Delirium, also known as metabolic encephalopathy or a change in mental status, is sudden severe confusion that occurs with physical or mental illness. Delirium is a medical emergency. Sequelae of delirium may persist for up to 6 months and it is associated with poor clinical outcomes including risk of death in the hospital, prolonged length of stay and increased need for SNF placement.
Identifying patients at risk is a cornerstone of delirium prevention. Patients who have previously experienced delirium are at risk for recurrence. For instance, patients who present for perioperative assessments with a history of hospital or post anesthesia delirium should have delirium risk addressed. Patients with all causes of dementia and those with mild cognitive impairment are also at risk. Consider also patients with alcohol, analgesic and anxiolytic withdrawal as being at risk for hospital based delirium.