Delirium

Question 1

What are the subtypes of delirium and their frequency?

Answer 1

Hypoactive 25-30%
Hyperactive 25%
Mixed 45%

Question 2

What is the 4AT and what questions does it include?

Answer 2

Delirium screening tool
90% sensitive and 85% specific
Includes: alertness, AMT4 (age, DOB, place), Attention (months of year in reverse order), fluctuating course.

Question 3

How long does delirium last?

Answer 3

Discharge 44%
1 month 32 %
3 months 25%
6 months 21%

Question 4

In patients >70, what are the 6 factors that best predict delirium?

Answer 4

Previous dementia or delirium
Sleep deprivation
Immobility
Visual impairment
Hearing impairment
dehydration

Question 5

What is the hazard ratio for death for those with delirium?

How much does the risk of mortality increase with every additional 48 hours of delirium?

Answer 5

HR 1.95 to 2.11

11%

Question 6

Is there any evidence for the use of antipsychotics in managing delirium?

Answer 6

no

Question 7

What is attenuated delirium syndrome?

What is the frequency within hospitalised elderly patients?

Answer 7

Dont meet full diagnostic criteia for delirium

Occurs in 21-76% of hospitalised elderly patients

Question 8

DSM V criteria for delirium

Answer 8

1. Disturbance of attention
2. Disturbance develops over a short period of time
3. Disturbance in cognition
4. points 1 and 3 are not better explained by an pre-existing or alternate neurocognitive disorder
5. evidence that the disturbance is a direct physiological consequence of another contition or medications