Description

Delirium is currently a neglected condition in hospital inpatients. It occurs in up to a third of general hospital admissions, but its diagnosis is missed in up to two-thirds of these patients. Its occurrence predicts increased mortality and increased dependency in patients. Impairments associated with the episode of delirium may take many months to resolve.

There are identifiable risk factors associated with its onset, and modification of these factors can reduce incidence of delirium in hospital inpatients.

The diagnosis of delirium is aided by the use of one of a number of scoring methods, such as the Delirium Rating Scale and Confusion Assessment Method. This review provides an overview of several of these scales and shows how different scales are appropriate for use by different members of the multi-disciplinary team.

A summary of the common risk factors and causes, as well as useful investigations is provided. Treatment of delirium is most effective when the underlying cause is treated, however additional environmental changes are at least as important as pharmacological control of symptoms.