Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Feb;40(1):45-57.
doi: 10.1016/j.ncl.2021.08.004.

Approach to Altered Mental Status and Inpatient Delirium

Sara C LaHue  1 , Vanja C Douglas  2
Affiliations
Review

Approach to Altered Mental Status and Inpatient Delirium

Sara C LaHue et al. Neurol Clin. 2022 Feb.

Abstract

Altered mental status is a nonspecific diagnosis that encompasses a wide spectrum of disease and is frequently cited as a reason for both hospital admission and inpatient neurologic consultation. There are numerous etiologies of altered mental status, and so although many are facile with the workup of this potentially life-threatening entity, it can nevertheless be overwhelming. Our goal was to provide a practical framework embedded in a current, comprehensive review of the epidemiology, clinical evaluation, and management of undifferentiated altered mental status. We pay particular attention to the management of a critical yet underdiagnosed subtype of altered mental status: delirium.

Keywords: Altered mental status; Delirium; Elderly; Encephalopathy; Hospitalized; Inattention; Inpatient; Postoperative.

PubMed Disclaimer

Conflict of interest statement

Disclosure Dr LaHue has nothing to disclose. Funding for Dr Douglas: Sara & Evan Williams Foundation Endowed Neurohospitalist Chair.

Figures

Fig. 1.
Fig. 1.
Delirium care pathway.
See this image and copyright information in PMC

References

    1. Smith AT, Han JH. Altered mental status in the emergency department. Semin Neurol 2019;39(1):5–19. - PubMed
    1. Wijdicks EFM. Metabolic encephalopathy: behind the name. Neurocrit Care 2018;29(3):385–7. - PubMed
    1. American Psychiatric Association. Desk reference to the diagnostic criteria from DSM-5. Arlington, Va: American Psychiatric Association; 2013.
    1. Wofford JL, Loehr LR, Schwartz E. Acute cognitive impairment in elderly ED patients: etiologies and outcomes. Am J Emerg Med 1996;14(7):649–53. - PubMed
    1. Hustey FM, Meldon SW. The prevalence and documentation of impaired mental status in elderly emergency department patients. Ann Emerg Med 2002;39(3):248–53. - PubMed