Delirium Etiologies
Etiology
Medications
Examples
Anticholinergic medications (TCAs, antihistamines, antispasmodics, antipsychotics, paroxetine, promethazine), sedatives, narcotics, corticosteroids, dopamine agonists, polypharmacy.
Etiology
Infections
Examples
UTI, pneumonia, acute cholecystitis, appendicitis, meningitis.
Etiology
Neurologic
Examples
Subdural hemorrhage, intracerebral hemorrhage, CVA, TIA, brain tumor.
Etiology
Metabolic
Examples
Hyponatremia or hypernatremia, hypoglycemia or hyperglycemia, dehydration, AKI, uremia
Etiology
Cardiopulmonary
Examples
Ischemia, arrhythmia, dissection, aspiration, COPD exacerbation, CHF exacerbation
Etiology
Substance use
Examples
Alcohol, opioid, benzodiazepine, illicit drug use or withdrawal.
Etiology
Other medical causes
Examples
Urinary retention, fecal impaction, uncontrolled pain, hip fracture.
Etiology
Environmental
Examples
Lack of sleep, hearing or visual loss, hypo- or hyper-stimulating environment for patients with dementia, new placement in patients with dementia.
References
Alagiakrishnan K et al. Postgrad Med J. 2004;80(945):388–393
Inouye SK et al. Lancet. 2014;383(9920):911–922
Wilson LA et al. In: Busby-Whitehead J et al, eds. Reichel’s Care of the Elderly: Clinical Aspects of Aging. 7th ed. Cambridge, UK: Cambridge University Press; 2016:148–156
Abbreviations
AKI, acute kidney injury
CHF, congestive heart failure
COPD, chronic obstructive pulmonary disease
CVA, cerebrovascular accident (stroke)
TCAs, tricyclic antidepressants
TIA, transient ischemic attack (mini-stroke)
UTI, urinary tract infection