risk factors for delirium

Last edited 04/2018

Risk factors of delirium can be divided into:

  • predisposing factors
    • comorbidities
      • alcoholism
      • chronic pain
      • history of baseline lung, liver, kidney, heart or brain disease
      • terminal illness
    • demographic factors
      • age older than 65 years
      • male sex
    • geriatric syndrome
      • dementia
      • depression
      • elder abuse
      • falls
      • history of delirium
      • malnutrition
      • polypharmacy
      • pressure ulcers
    • premorbid state
      • inactivity
      • poor functional status
      • social isolation
  • precipitating factors
    • acute insults
      • dehydration
      • fracture
      • infection
      • ischemia – cerebral, cardiac
      • medications
      • metabolic derangements
      • poor nutrition
      • severe illness
      • shock
      • surgery
      • uncontrolled pain
    • environmental exposure
      • ICU setting
      • sleep deprivation
  • delirium-inducing medications
    • high risk
      • anticholinergics - e.g., antihistamines, muscle relaxants, antipsychotics)
      • benzodiazepines
      • dopamine agonists
    • moderate to low risk
      • antibiotics (e.g., quinolones, antimalarials, isoniazid, linezolid [Zyvox], macrolides)
      • anticonvulsants
      • antihypertensives (e.g., beta blockers, clonidine
      • sedatives/hypnotics
      • tricyclic antidepressants
      • low-potency antihistamines (e.g., histamine H2 blockers, urinary and gastrointestinal antispasmodics) (1)

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