- Psychiatric Annals
- January 2010 - Volume 40 · Issue 1: 52-62
Delirium, a condition marked by changes in clinical and mental status, has increasingly been understood as prevalent and dangerous, particularly among elderly or frail patients. It is caused by medical or surgical problems and medication burdens that are beyond the physiological tolerance of the patient. Delirium occurs in 15% to 60% of nursing home patients, 14% to 56% of inpatients, and up to 60% to 87% of patients in the intensive care unit (ICU).1–3
Delirium is now understood as an independent risk factor for death and dementia.4
About 22% to 76% of patients who are hospitalized with delirium die.1
Patients with delirium have more inpatient complications,5
they more frequently transition to dependent living settings, and they have significant rates of new dependency in instrumental activities in daily living (IADLs) and activities of daily living (ADLs), especially after episodes of delirium in the ICU.6
Deliriums that are more severe or persistent have worse outcomes. Delirium costs $38 billion to $152 billion per year.7
In ICUs alone, episodes of delirium average 39% higher ICU costs and 31% higher hospital costs, largely related to length of stay.
Barbara Kamholz, MD, is with the Department of Psychiatry, Durham VA Medical Center, Durham, North Carolina, and is on the teaching faculty at the Department of Psychiatry, Duke University.
Dr. Kamholz has disclosed no relevant financial relationships.
Address correspondence to: Barbara Kamholz, MD; e-mail: .Barbara.email@example.com