• J Psychosom Res · Sep 2008

    Review

    Predisposing and precipitating factors for delirium in a frail geriatric population.

    • Jouko V Laurila, Marja-Liisa Laakkonen, Jouko Valdemar Laurila, Strandberg E Timo, Reijo S Tilvis, Tilvis S Reijo, and Kaisu H Pitkala.
    • Departments of Internal Medicine and Geriatrics [corrected] Helsinki University Central Hospital, Finland. jouko.laurila@hus.fi
    • J Psychosom Res. 2008 Sep 1; 65 (3): 249-54.

    ObjectiveThe aim of this study was to assess the possible predisposing aetiologic and short-term precipitating factors for delirium in acutely ill hospital patients with a heavy burden of comorbidities and medications.MethodsEighty-seven consecutive patients with acute delirium admitted to a general medicine unit were thoroughly examined, and the predisposing and precipitating factors of their delirium were assessed.ResultsIn this population, an average of 5.2 predisposing factors and 3.0 potential precipitating factors for delirium was revealed, meaning an average of over eight possible aetiological causes for each patient. The most common precipitating factors were infections (n=72), metabolic abnormalities (n=52), adverse drug effects (n=41), and cardiovascular events (n=38). In addition, a number of very rare conditions were diagnosed after thorough assessments.ConclusionGeriatric patients with acute delirium typically present with several concomitant predisposing factors for delirium exposing them to high vulnerability for the syndrome. In most patients, a number of possible etiological causes for delirium can be identified after a careful assessment, but their true pathogenetic pathway to the syndrome is unclear.

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