Predisposing and precipitating factors for delirium in a frail geriatric population.
OBJECTIVE
The aim of this study was to assess the possible predisposing aetiologic and short-term precipitating factors for delirium in acutely ill hospital patients with a heavy burden of comorbidities and medications.


METHODS
Eighty-seven consecutive patients with acute delirium admitted to a general medicine unit were thoroughly examined, and the predisposing and precipitating factors of their delirium were assessed.


RESULTS
In this population, an average of 5.2 predisposing factors and 3.0 potential precipitating factors for delirium was revealed, meaning an average of over eight possible aetiological causes for each patient. The most common precipitating factors were infections (n=72), metabolic abnormalities (n=52), adverse drug effects (n=41), and cardiovascular events (n=38). In addition, a number of very rare conditions were diagnosed after thorough assessments.


CONCLUSIONS
Geriatric patients with acute delirium typically present with several concomitant predisposing factors for delirium exposing them to high vulnerability for the syndrome. In most patients, a number of possible etiological causes for delirium can be identified after a careful assessment, but their true pathogenetic pathway to the syndrome is unclear.
Laurila
Jouko V
JV
Departments of Internal Medicine and Geriatrics [corrected] Helsinki University Central Hospital, Finland. jouko.laurila@hus.fi
Laakkonen
Marja-Liisa
ML
Laurila
Jouko Valdemar
JV
Timo
Strandberg E
SE
Tilvis
Reijo S
RS
Reijo
Tilvis S
TS
Pitkala
Kaisu H
KH
D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000453:epidemiology* / Q000503:physiopathology*; D016330:Frail Elderly; D006801:Humans; D012307:Risk Factors