Rolfson listed factors that can predispose a patient to delirium or precipitate an episode. These can help identify a patient who may benefit from closer monitoring and more aggressive management.


Factors that predispose to delirium:

(1) older age (> 70 years of age)

(2) male gender

(3) comorbid conditions (see below)

(4) functional dependence

(5) hip fracture

(6) stroke

(7) dehydration

(8) metabolic disorder


Comorbid conditions that may predispose to delirium:

(1) visual impairment

(2) dementia, especially severe dementia

(3) depression

(4) immobility

(5) alcoholism

(6) severe physical illness


Precipitating factors:

(1) drugs (narcotics, anticholinergic agents, others)

(2) surgery (orthopedic, cardiac, non-cardiac)

(3) severe acute illness

(4) ICU admission

(5) infection (urinary tract, other)

(6) hyponatremia

(7) hypoxemia

(8) anemia

(9) pain

(10) shock

(11) physical restraint

(12) high number of hospital procedures (usually associated with more severe illness)

(13) iatrogenic event

(14) prolonged cardiopulmonary bypass

(15) use of a urinary bladder catheter


Others not listed:

(1) sleep deprivation or poor sleep quality


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