Inouye and Charpentier identified precipitating factors for delirium in an elderly patient in the hospital. These can help to identify a patient who may benefit from more aggressive management. The authors are from Yale University.
Patient selection: age >= 70 years, admitted to hospital with no delirium at baseline
Parameters:
(1) need for physical restraints
(2) malnutrition
(3) number of medications added
(4) urinary bladder catheter
(5) iatrogenic event
|
Parameter |
Finding |
Points |
|
physical restraints |
no |
0 |
|
|
yes |
1 |
|
Malnutrition |
absent |
0 |
|
|
present |
1 |
|
number of medications added |
<= 3 |
0 |
|
|
> 3 |
1 |
|
urinary bladder catheter |
absent |
0 |
|
|
present |
1 |
|
iatrogenic event |
none |
0 |
|
|
any |
1 |
where:
• The need for physical restraints may be a sign of delirium rather than a factor.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk for delirium.
|
Score |
Risk for Delirium |
Percent |
|
0 |
low |
3-4% |
|
1 or 2 |
intermediate |
20% |
|
3 to 5 |
high |
35-59% |
Specialty: Neurology
