Delirium: A Review of Risk Factors and Diagnosis

Abstract

Background: Delirium is one of the neuropsychiatric syndromes that are characterized by several impairments in consciousness and cognitive function. It is a condition that is very commonly encountered in hospital settings. Delirium is associated with higher risks for unfavorable outcomes, extended hospital stay and also higher mortality. It therefore becomes essential to understand the phenomenology and risk factors of delirium in an effort to ensure proper diagnosis and treatment.
Methods: This cross-sectional study was conducted on 50 patients referred to the consultation liaison psychiatry department within the age group of 16 to 60 years at SCB Medical College, Cuttack. A thorough collection of sociodemographic and clinical data along with the assessment of the severity of delirium by using Delirium Rating Scale Revised 98 (DRS-R98) was done on the patients through various laboratory investigations to assess the underlying medical conditions.
Results: There was a male preponderance of 57% and significant alcohol dependence (38%). There was predominance of hyperactive delirium as the presentation in this group (68%), with DRS-R98 score significantly higher compared to that in the ICU group (19.68 ± 8.89 vs 15.32 ± 8.26). Several clinical factors like deranged liver and renal functions, were precipitant and contributory factors to the severity of delirium.
Conclusion: The results underscore the multifactorial and polymorphic nature of delirium in hospitalized patients. Early detection and appropriate management are thus underscored in these settings. The significant differences observed in the severity of delirium in different settings advocate for individualized interventions and use of diagnostic tools validated to improve the outcome of patients.