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STEP 1: Identify who is at risk for developing delirium
Recognition
Table 1. Predisposing Factors or Vulnerability
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• Age 75 or older (RR=3.3-6.6)
• Dementia (RR=2.3-4.7)
• Prior delirium (RR=3.0)
• Functional impairment (RR=2.5-4.0)
• Visual impairment (RR=1.1-3.5)
• Hearing impairment (RR=1.3)
• Depression (RR=1.2-3.2)
• Prior TIA or CVA (RR=1.60)
• Alcohol misuse (RR=1.4–5.7)
• Comorbidity/severity of illness (RR=1.3–5.6)
STEP 2: Modify risk factors if possible
➤ Consider use of the Anticholinergic Cognitive Burden Scale to review
patient's medication list.
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Table 2. Precipitating Factors or Noxious Insults
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• Medications (sedatives/psychoactives) (RR=2.9-4.5)
• Indwelling bladder catheters (RR=2.4)
• Physical restraints (RR=3.2-4.4)
• Fluid/electrolyte abnormalities (RR=3.4)
• Infections (RR=3.1)
• Surgery hospital admission (RR=3.5-8.3)
• Trauma hospital admission (RR=3.4)
• Urinary retention and fecal impaction
• Physical restraints (RR=3.2-4.4)
• Uncontrolled pain
• Interrupted sleep, noise
• ETOH/drug withdrawal
