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Review
. 2010 Aug;28(3):611-31.
doi: 10.1016/j.emc.2010.03.005.

Delirium in the older emergency department patient: a quiet epidemic

Jin H Han  1 , Amanda Wilson, E Wesley Ely
Affiliations
Review

Delirium in the older emergency department patient: a quiet epidemic

Jin H Han et al. Emerg Med Clin North Am. 2010 Aug.

Abstract

Delirium is defined as an acute change in cognition that cannot be better accounted for by a preexisting or evolving dementia. This form of organ dysfunction commonly occurs in older patients in the emergency department (ED) and is associated with a multitude of adverse patient outcomes. Consequently, delirium should be routinely screened for in older ED patients. Once delirium is diagnosed, the ED evaluation should focus on searching for the underlying cause. Infection is one of the most common precipitants of delirium, but multiple causes may exist concurrently.

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Figures

Figure 1
Figure 1
The interrelationship between patient vulnerability and precipitating factors in the development of delirium. Patients who have little vulnerability require significant noxious stimuli to develop delirium (black arrow). Conversely, patients who are highly vulnerable require only minor noxious stimuli to develop delirium (gray arrow).
Figure 2
Figure 2
Features of the Confusion Assessment Method. A patient must have both features 1 and 2, and either 3 or 4 to meet criteria for delirium.
Figure 3
Figure 3
Algorithm for performing the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in the clinical setting. The shaded hexagons indicate a stopping point for the CAM-ICU.
See this image and copyright information in PMC

References

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