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Evaluation and Management of Delirium
Sophia L Ryan1, Eyal Y Kimchi2
1Department of Neurology, Mount Sinai Medical Center, New York, New York.
Seminars in Neurology
|October 7, 2021
Summary
Delirium, an acute confusional state, is common in hospitalized patients and often unrecognized. Early diagnosis and management, focusing on nonpharmacologic interventions, can improve patient outcomes and care.
Area of Science:
- Neurology
- Geriatrics
- Critical Care Medicine
Background:
- Delirium, or acute confusional state, is prevalent in hospitalized patients and linked to adverse outcomes.
- It is frequently underdiagnosed by healthcare teams, despite being a common neurological consultation.
- Neurologic conditions like dementia or aphasia can be misdiagnosed as delirium or co-occur, complicating assessment.
Purpose of the Study:
- To highlight the significance of recognizing and managing delirium in hospitalized patients.
- To emphasize the role of neurologists in diagnosing and treating delirium.
- To underscore the importance of a comprehensive, nonpharmacologic approach to delirium management.
Main Methods:
- Systematic review of existing literature on delirium diagnosis and management.
- Analysis of clinical presentation and diagnostic challenges in differentiating delirium from other neurologic syndromes.
- Evaluation of multicomponent, nonpharmacologic interventions for delirium prevention and treatment.
Main Results:
- Delirium is often unrecognized, leading to delayed or inadequate care.
- Accurate neurologic assessment is crucial for distinguishing delirium from dementia or aphasia.
- Identifying and addressing predisposing and precipitating factors is key to effective management.
Conclusions:
- Early recognition and diagnosis of delirium are critical for improving patient outcomes.
- A comprehensive, multicomponent, nonpharmacologic intervention strategy is recommended.
- Neurologists play a vital role in enhancing care for patients with delirium, emphasizing their humanity and vulnerability.
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