Review Article
Volume 16 Issue 2 - 2020
Delirium in Elderly
Nasreen Abdullah Ashour1*, Esraa Saleh Heji2, Mishaal Hisham Rayees3, Hawra Abdulkhaliq Al Shali4, Raed Saeed Alajrafi5, Talib Abdulaziz Aldakhil6, Malak Mahmoud Kurdi7, Suhaib Mohammed Amin Khan8, Ngoud Moghli Alaslani9, Rawan Abdullah Alsaedi10 and Abdullah Saeed Abu-kaftah11
1King Fahad General Hospital, Jeddah, Saudi Arabia
2Umm Al-Qura University, Saudi Arabia
3King Abdulziz University Hospital, Saudi Arabia
4Qatif Primary Healthcare, Saudi Arabia
5Imam Abdulrahman Bin Faisal University, Saudi Arabia
6Alqatif Central Hospital, Saudi Arabia
7Taibah University, Saudi Arabia
8King Abdulaziz University, Saudi Arabia
9King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia
10Ibn Sina College, Saudi Arabia
11Armed Force Hospital Southern Region, Saudi Arabia
*Corresponding Author: Nasreen Abdullah Ashour, King Fahad General Hospital, Jeddah, Saudi Arabia.
Received: January 04, 2020; Published: January 08, 2020




Abstract

Introduction: Delirium is defined as a clinical syndrome which is characterized by acute and fluctuating cognitive dysfunction, or acute state of confusion, which is usually transient, and happens as a result of another underlying medical condition. The prevalence of delirium in about 14 - 24% in hospital setting and 1 - 2% in community. The incidence is higher among the elderly, especially those in post-operative stage, in palliative care, or those requiring intensive care. Patients over age 65 in the intensive care unit (ICU) can haven in incidence of delirium as high as 85%. Delirium is also greatly associated with patients on ventilators. Delirium is associated with a cost of 4 - 16 billion dollars per year in the United States alone. It is also associated with increased duration of mechanical ventilation, rates of self extubation and prolonged hospital stay. Prolonged delirium in the ICU is directly associated with increased mortality, as well as long term cognitive dysfunction. Therefore, understanding the cause behind the condition, and its management is imperative. 

Objectives: In this review, we will discuss the management of delirium of patients in the intensive care department.

Methodology: We did a systematic search for management of delirium of patients in the intensive care department using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles.

Conclusion: Delirium is a serious condition and a complication of hospitalization patients, especially in the elderly. It must be considered to be a medical emergency until proven otherwise. Delirium has the potential to significantly affect the overall outcome and prognosis of severely ill patients in the ICU. It also substantially increases the health-care utilization and costs. Interdisciplinary team approach with new guidelines for managing delirium leads use minimum sedation, reduced duration of mechanical ventilation, increase ventilator-free days, and better sleep hygiene. Restraints should only be used in refractory cases. More studies are needed to understand causes and risk factors for delirium to reduce incidence and enhance prevention in the ICU patients. 

Keywords: Delirium; Acute Confusion; Intensive Care Unit; Palliative Care; Treatment of Delirium

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Citation: Nasreen Abdullah Ashour., et al. “Delirium in Elderly”. EC Microbiology 16.2 (2020): 01-08.

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