Journal
BEST PRACTICE & RESEARCH-CLINICAL ANAESTHESIOLOGY
Volume 26, Issue 3, Pages 277-287Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.bpa.2012.07.003
Keywords
delirium; epidemiology; prevalence; incidence; risk factors
Categories
Funding
- National Institutes of Health [R01 AG035117-02, R01 AG 027472-05, K23AG040157, K23AG032355]
- Veterans Affairs Clinical Research Center of Excellence
- Tennessee Valley Geriatric Research, Education and Clinical Center (GRECC)
- Foundation for Anaesthesia Education and Research Mentored Research Training Grant
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Delirium is one of the most common causes of acute end-organ dysfunction across hospital settings, occurring in as high as 80% of critically ill patients that require intensive care unit (ICU) care. The implications of this acute form of brain injury are profound. Across many hospital settings (emergency department, general medical ward, postoperative and ICU), a patient who experiences delirium is more likely to experience increased short-and long-term mortality, decreases in long-term cognitive function, increases in hospital length of stay and increased complications of hospital care. With the development of reliable setting-specific delirium-screening instruments, researchers have been able to highlight the predisposing and potentially modifiable risk factors that place patients at highest risk. Among the large number of risk factors discovered, administration of potent sedative medications, most notably benzodiazepines, is most consistently and strongly associated with an increased burden of delirium. Alternatively, in both the hospital and ICU, delirium can be prevented with the application of protocols that include early mobility/exercise. Future studies must work to understand the epidemiology across settings and focus upon modifiable risk factors that can be integrated into existing delirium prevention and treatment protocols. Published by Elsevier Ltd.
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