Delirium: current trends in prevention and treatment

Authors

  • J. B. Weber,

    1. Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and
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  • J. H. Coverdale,

    1. Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and
    2. Division of Psychiatry, University of Auckland, Auckland, New Zealand
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  • M. E. Kunik

    1. Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine and
    2. Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, Houston, Texas, USA and
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  • Funding: None

    Conflicts of interest: None

Mark E. Kunik, Veterans Affairs Medical Center, Mailstation 152, 2002 Holcombe Boulevard, Houston, TX 77030, USA. Email: mkunik@bcm.tmc.edu

Abstract

Abstract

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognised and treated by physicians. Predisposing factors are believed to have multiplicative effects and include dementia, advanced age and male gender. Recently developed models allow for the estimation of the risk of developing delirium during a hospitalisation, based on predisposing factors and acute additional stressors. Although it has been shown to be efficacious, the prevention of delirium is underutilised. Prevention consists of aggressive management of known risk factors and early detection. Limited data exist to support specific pharmacological interventions for its treatment. In this article, the avail­able published literature regarding the prevention and treatment of delirium is systematically reviewed. (Intern Med J 2004; 34; 115−121)

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