title: Delirium: clinical approach and prevention.
abstract: Delirium, defined as an acute fluctuating change in mental state, with consciousness and cognitive impairment, has been found to have a high incidence in hospitalised patients, as well as being associated with increased morbidity and mortality, prolonged stays in the intensive care unit (ICU) and in hospital and higher costs. However, delirium is not easy to detect, since its diagnosis is mainly clinical. Yet the importance of early diagnosis and possible prevention in the different clinical scenarios is clear, to improve patient prognosis. This review provides a practical approach to delirium management through: (a) its classification and diagnosis utilising validated tools and (b) the use of non-pharmacological protocols and of an early prediction model to identify high-risk patients, who are more likely to benefit from pharmacological prophylaxis.
authors.affiliation: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti, Università degli Studi di Milano, A.O. San Paolo-Polo Universitario, Milan, Italy. giovanni.mistraletti@unimi.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mistraletti
authors.forename: Paolo
authors.initials: P
authors.lastname: Pelosi
authors.forename: Elena Silvia
authors.initials: ES
authors.lastname: Mantovani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Berardino
authors.forename: Cesare
authors.initials: C
authors.lastname: Gregoretti
mesh_terms: D003693:Delirium / Q000175:diagnosis / Q000517:prevention & control*; D042241:Early Diagnosis; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008954:Models, Biological; D011379:Prognosis