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Delirium: Risk Factors, Contributors, Identification, Work-Up, and Treatment

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Inpatient Geriatric Psychiatry

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Abstract

Delirium is a common, serious, and life-threatening condition that is often missed and poorly managed. Increasing evidence argues that health-care providers need to assess the mental status of the patient as the “sixth vital sign.” Although functional neuroimaging and CSF biomarkers are being studied in delirium management, the diagnosis is a clinical one without a laboratory test or imaging to confirm it.

Delirium is associated with increased morbidity, mortality, slower rate of recovery, poor functional and cognitive recovery, decreased quality of life, hospital-acquired complications, placement in specialized intermediate and long-term care facilities, increased cost of care, and prolonged hospital stays. Management includes the rapid identification of the cause(s), and correcting it/them if possible. Managing risk factors such as dehydration, infection, polypharmacy, immobility, restraints, and sensory impairment is key in both identifying the cause and reducing the consequences and optimizing patient care. This chapter will explore the identification, work-up, risk factors, and management of this important condition.

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Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Ottawa, Department of Psychiatry, Geriatric Psychiatry Inpatient Unit, The Royal, Ottawa, ON, Canada

    Timothy Lau

  2. Memorial University School of Pharmacy, Ottawa, ON, Canada

    Elizabeth Kozyra

  3. Department of Psychiatry, University of Alberta, Edmonton, AB, Canada

    Catherine Cheng

  4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Catherine Cheng

Authors
  1. Timothy Lau
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  2. Elizabeth Kozyra
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  3. Catherine Cheng
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Corresponding author

Correspondence to Timothy Lau .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Stanford/VA Alzheimer’s Center, VA Health Care System, Palo Alto, CA, USA

    Howard H. Fenn

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Ana Hategan

  3. Department of Psychiatry, Baylor Scott and White Central Texas, Division College of Medicine, Texas A & M University, Health Science Center, Temple, TX, USA

    James A. Bourgeois

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Lau, T., Kozyra, E., Cheng, C. (2019). Delirium: Risk Factors, Contributors, Identification, Work-Up, and Treatment. In: Fenn, H., Hategan, A., Bourgeois, J. (eds) Inpatient Geriatric Psychiatry . Springer, Cham. https://doi.org/10.1007/978-3-030-10401-6_12

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  • DOI: https://doi.org/10.1007/978-3-030-10401-6_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10400-9

  • Online ISBN: 978-3-030-10401-6

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