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Delirium

Elizabeth Patsio, MD and Nicholas M. Hajj, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • A temporary neurocognitive complication of illness and/or medication(s), especially common in older patients, manifested by new confusion and impaired attention

  • A medical emergency re...

DIAGNOSIS

Diagnosis is made using a careful history, behavioral observation, and cognitive assessment. 
  • Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnostic criteria include (1...

TREATMENT

  • The best treatment is prevention, and there is strong evidence for multicomponent non-pharmacological strategies

  • Strong evidence for multicomponent non-pharmacological interventions

  • The Hospit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • If delirium at discharge, often needs postacute facility care and ongoing assessment for resolution

  • If no delirium at discharge, follow up with primary care physic...

REFERENCES

1
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
2
Hshieh TT, Inouye SK, Oh ES. Deliriu...

ADDITIONAL READING

SEE ALSO

  • Dementia; Depression; Substance Use Disorders

  • Algorithm: Delirium

CODES

ICD10

  • R41.0 Disorientation, unspecified

  • F19.931 Oth psychoactive substance use, unsp w withdrawal delirium

  • F10.231 Alcohol dependence with withdrawal delirium

  • F05 Delirium due to known physiological...

CLINICAL PEARLS

  • The criteria for delirium include an acute onset of fluctuating mental status, inattention, and either disorganized thinking or altered level of consciousness.

  • Primary treatment for del...

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