Delirium natural history, complications and prognosis: Difference between revisions
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* After remission , [[delirium]] may increase the risk of functional decline, [[cognitive dysfunction]], and [[institutional placement]], and with higher [[mortality]].<ref name="McNicollPisani2003">{{cite journal|last1=McNicoll|first1=Lynn|last2=Pisani|first2=Margaret A.|last3=Zhang|first3=Ying|last4=Ely|first4=E. Wesley|last5=Siegel|first5=Mark D.|last6=Inouye|first6=Sharon K.|title=Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients|journal=Journal of the American Geriatrics Society|volume=51|issue=5|year=2003|pages=591–598|issn=00028614|doi=10.1034/j.1600-0579.2003.00201.x}}</ref> | * After remission , [[delirium]] may increase the risk of functional decline, [[cognitive dysfunction]], and [[institutional placement]], and with higher [[mortality]].<ref name="McNicollPisani2003">{{cite journal|last1=McNicoll|first1=Lynn|last2=Pisani|first2=Margaret A.|last3=Zhang|first3=Ying|last4=Ely|first4=E. Wesley|last5=Siegel|first5=Mark D.|last6=Inouye|first6=Sharon K.|title=Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients|journal=Journal of the American Geriatrics Society|volume=51|issue=5|year=2003|pages=591–598|issn=00028614|doi=10.1034/j.1600-0579.2003.00201.x}}</ref> | ||
* [[Delirium]] in the elderly, can cause many complications, which may include [[pneumonia]] and [[decubitus ulcers]], prolonging [[hospital]] stays. | * [[Delirium]] in the elderly, can cause many complications, which may include [[pneumonia]] and [[decubitus ulcers]], prolonging [[hospital]] stays. | ||
* Up to 25% of patients with [[delirium ]] die within 6 months and that their [[mortality]] rate in the 3 months after diagnosis is 14 times as high as the [[mortality]] rate for [[patients]] with affective disorders. | * Up to 25% of patients with [[delirium ]] die within 6 months and that their [[mortality]] rate in the 3 months after diagnosis is 14 times as high as the [[mortality]] rate for [[patients]] with affective disorders. | ||
*After one episode of [[delirium]], the mortality rate was 24%-76% within one year. | |||
* [[Delirium]] was associated with longer postoperative recovery periods, longer hospital stays, and long-term disability after [[orthopedic]] surgery.<ref name="www.ncbi.nlm.nih.gov">{{Cite web | last = | first = | title = Practice guideline for the treatment of pati... [Am J Psychiatry. 1999] - PubMed - NCBI | url = http://www.ncbi.nlm.nih.gov/pubmed/10327941 | publisher = | date = | accessdate = }}</ref> | * [[Delirium]] was associated with longer postoperative recovery periods, longer hospital stays, and long-term disability after [[orthopedic]] surgery.<ref name="www.ncbi.nlm.nih.gov">{{Cite web | last = | first = | title = Practice guideline for the treatment of pati... [Am J Psychiatry. 1999] - PubMed - NCBI | url = http://www.ncbi.nlm.nih.gov/pubmed/10327941 | publisher = | date = | accessdate = }}</ref> | ||
*Common complications associated with [[delirium]] include increased [[mortality]], [[cognitive impairment]], longer durations of [[mechanical ventilation]], longer lengths of stay in the [[ICU]].<ref name="SalluhWang2015">{{cite journal|last1=Salluh|first1=J. I. F.|last2=Wang|first2=H.|last3=Schneider|first3=E. B.|last4=Nagaraja|first4=N.|last5=Yenokyan|first5=G.|last6=Damluji|first6=A.|last7=Serafim|first7=R. B.|last8=Stevens|first8=R. D.|title=Outcome of delirium in critically ill patients: systematic review and meta-analysis|journal=BMJ|volume=350|issue=may19 3|year=2015|pages=h2538–h2538|issn=1756-1833|doi=10.1136/bmj.h2538}}</ref> | *Common complications associated with [[delirium]] include increased [[mortality]], [[cognitive impairment]], longer durations of [[mechanical ventilation]], longer lengths of stay in the [[ICU]].<ref name="SalluhWang2015">{{cite journal|last1=Salluh|first1=J. I. F.|last2=Wang|first2=H.|last3=Schneider|first3=E. B.|last4=Nagaraja|first4=N.|last5=Yenokyan|first5=G.|last6=Damluji|first6=A.|last7=Serafim|first7=R. B.|last8=Stevens|first8=R. D.|title=Outcome of delirium in critically ill patients: systematic review and meta-analysis|journal=BMJ|volume=350|issue=may19 3|year=2015|pages=h2538–h2538|issn=1756-1833|doi=10.1136/bmj.h2538}}</ref> | ||
Revision as of 12:51, 8 April 2021
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Delirium Microchapters |
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Diagnosis |
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Treatment |
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Delirium On the Web |
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American Roentgen Ray Society Images of Delirium |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Pratik Bahekar, MBBS [3]; Vishal Khurana, M.B.B.S., M.D. [4]
Overview
History, complication of delirium and prognosis depends for many factors such as, etiology, risk factors, and co-morbid illness.
History
- The duration of delirium is typically affected by the underlying cause.
- If caused by a fever, the delirious state often subsides as the severity of the fever subsides.
- Ranges from less than a week to more than 2 months.
- Most of the time symptoms resolve by 10 to 12 days.
- Up to 15% of patients, typically elderly, delirium may last for a month and beyond.
- Delirium associated with substance withdrawal develops when concentrations of the substance in fluid and tissue decrease after sustained, high-dose use of certain substances.
Complications and Prognosis
- The duration of delirium may vary from days to months.[1]
- After remission , delirium may increase the risk of functional decline, cognitive dysfunction, and institutional placement, and with higher mortality.[2]
- Delirium in the elderly, can cause many complications, which may include pneumonia and decubitus ulcers, prolonging hospital stays.
- Up to 25% of patients with delirium die within 6 months and that their mortality rate in the 3 months after diagnosis is 14 times as high as the mortality rate for patients with affective disorders.
- After one episode of delirium, the mortality rate was 24%-76% within one year.
- Delirium was associated with longer postoperative recovery periods, longer hospital stays, and long-term disability after orthopedic surgery.[3]
- Common complications associated with delirium include increased mortality, cognitive impairment, longer durations of mechanical ventilation, longer lengths of stay in the ICU.[4]
- Prognosis is dependent on the severity of delirium, and the 1 year mortality rate of patients with delirium is approximately 10%-26%.[5]
References
- ↑ Rudberg, Mark A; Pompei, Peter; Foreman, Marquis D.; Ross, Ruth E.; Cassel, Christine K. (1997). "The natural history of delirium in older hospitalized patients: a syndrome of heterogeneity". Age and Ageing. 26 (3): 169–174. doi:10.1093/ageing/26.3.169. ISSN 0002-0729.
- ↑ McNicoll, Lynn; Pisani, Margaret A.; Zhang, Ying; Ely, E. Wesley; Siegel, Mark D.; Inouye, Sharon K. (2003). "Delirium in the Intensive Care Unit: Occurrence and Clinical Course in Older Patients". Journal of the American Geriatrics Society. 51 (5): 591–598. doi:10.1034/j.1600-0579.2003.00201.x. ISSN 0002-8614.
- ↑ "Practice guideline for the treatment of pati... [Am J Psychiatry. 1999] - PubMed - NCBI".
- ↑ Salluh, J. I. F.; Wang, H.; Schneider, E. B.; Nagaraja, N.; Yenokyan, G.; Damluji, A.; Serafim, R. B.; Stevens, R. D. (2015). "Outcome of delirium in critically ill patients: systematic review and meta-analysis". BMJ. 350 (may19 3): h2538–h2538. doi:10.1136/bmj.h2538. ISSN 1756-1833.
- ↑ McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E (February 2002). "Delirium predicts 12-month mortality". Arch Intern Med. 162 (4): 457–63. doi:10.1001/archinte.162.4.457. PMID 11863480.