What are the risk factors associated with delirium?
Delirium is a state of mental confusion or a syndrome characterised by fluctuating or decreasing cognitive impairment along with behavioural abnormalities. It may includes the following features: Global cognitive deficit, Varying conscious level, Memory impairment, Strange behaviour, Disordered thinking, Disturbed perception, Mood swings Risk factors of delirium are: PREDISPOSING FACTORS 1. Old age 2. Dementia 3. Frailty 4. Sensory impairment 5. Polypharmacy 6. Renal impairment PRECIPITATING FACTORS 1. Intercurrent illness 2. Surgery 3. Change of environment or ward 4. Sensory deprivation (e.g. darkness) or overload (e.g. noise) 5. Medications (opioids, psychotropics) 6. Dehydration 7. Pain 8. Constipation 9. Urinary catheterization 10. Acute urinary retention 11. Hypoxia 12. Fever 13. Alcohol withdrawal
The precipitating factors of delirium can be categorised into three categories: 1. MEDICAL: Infection (fever) Dyselectrolytemia like Hyponatremia Metabolic diseases Endocrine causes 2. SURGICAL: Post operative (anaesthesia like Ketamine) ICU stay (ICU psychosis) Head trauma 3. DRUGS: Anticholinergics (Datura, Atropine) Alcohol withdrawal (Delirium Tremens)