User:Mr. Ibrahem/Delirium

Delirium, also known as acute confusional state, is an altered level of consciousness that develops over a short period and fluctuates over time. There may be changes in attention, activity, awareness, sleep patterns, and ability to think. Onset is typically over hours to days and the person differs from their usual baseline mental functioning. In hospital, the condition typically lasts about a week, though some may have ongoing problems afterwards.

Delirium may be caused by a medical condition, medications, substance intoxication, or substance withdrawal. Often a number of factors are involved. Risk factors include dementia, vision problems, hearing problems, and alcoholism. Medications that may trigger the event include benzodiazepines, antihistamines, opioids, and antipsychotics. Other triggers may include infections, pain, or surgery. The underlying mechanism poorly understood.

Diagnose requires establishing a person's usual mental function. The person's activity may be increased (agitation), decreased (subdued), or be a mix of both. Cases were activity is decreased are more frequently missed or attributed to depression. It should be distinguished from psychotic disorders, acute stress disorder, and dementia.

Treatment is generally directed at the underlying causes. Other measures may include hearing aids, glasses, sufficient fluids to drink, a quiet sleep environment, and a visible clock. While antipsychotics are used, there is no evidence to support a benefit for delirium. Delirium in hospitalized people; however, can be reduced by systematic good general care. About 40% of people with delirium in hospital die within a year.

Delirium affects about 1 to 2% of people overall. Among older adults, rates are around 20% after surgery or when visiting the emergency department, and up to 90% in the intensive care unit. Rates around 20% are also seen among those admitted to hospital. The condition becomes more common with age, affecting about 14% of those over the age of 85. Descriptions of delirium date back to at least Hippocrates around 400 BC.