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precipitating factors associated with delirium
From reference [1]:
- surgical factor
- type of surgery
- intraoperative blood loss or transfusion
- intraoperative hemodynamics
- duration of surgery
- postoperative complication, atrial fibrillation or shock
- prolonged time to surgery
- anestheasia type & depth of anesthesia
- number of surgeries
- intraoperative fluids
- systemic illness or organ dysfunction
- neurological injury
- anemia
- organ dysfunction of high illness severity
- infection
- mechanical ventilation
- kidney injury
- pain
- hypoxemia
- leukocytosis
- fever or hypothermia
- stroke
- respiratory disease
- liver disfunction
- hypotension
- tachypnea
- stress, anxiety or depression
- high serum TSH
- clinical dehydration
- urinary retention
- thrombocytopenia
- cardiac arrest or cardiogenice shock
- unsafe swallow on admisssion
- metabolic abnormality
- serum glucose
- serum albumin
- electrolyte imbalance
- metabolic acidosis
- other metabolic disturbances
- serum sodium
- serum calcium
- hyperamylasemia
- serum potassium
- fluid level: hypervolemia, hypovolemia
- serum magnesium
- hyperoxia
- pharmaceuticals
- benzodiazepines
- opioids
- sedatives or analgesics
- neuroleptics
- anticholingergic agents
- multiple medications
- patient-controlled analgesia
- statin discontinuation
- mannitol
- psychoactive drugs
- steroids
- nicotine withdrawal
- acetylcholinesterase inhibitors
- nonsteroid anti-inflammatory drug
- iatrogenic or environmental factors
- urinary catheter
- physical restraint
- longer length of hospital stay
- ICU admission
- neurosurgical drainage tube
- sleep disturbance
- falls in the elderly
- bed or ward change
- immobilization
- nasogastric tube
- administration of therapy during the night
- any iatrogenic event
- trauma
- biomarkers
- high serum C-reactive protein
- high serum IL-6
- high serum neopterin
- high serum NT-proBNP
- high serum IL-8
- high serum S100B
- high serum cortisol
- low ubiquitin C-terminal hydrolase
- low cerebral oxygen saturation
- high micro-RNA-210
- low serum IGF-1
- high TNF-alpha
- low serum IL-10
- high CSF p-tau
- change in exosomal alpha-synuclein
- high serum procalcitonin
- endothelial dysfunction
- high CSF sTREM2
- burst suppression
- high sTNFR11
- low MMP-9
- low plasma protein C
- high plasma plasminogen activator inhibitor
- high E-selectin
- high reactive hyperemia index (endothelial activation)
- high CSF total tau
- autoregulation function
- high serum IL-2
- altered energy metabolism & amino acid synthesis
- high Lp-PLA2
- neurotransmitters
- high CSF tryptophan or serum tryptophan
- low CSF BuChE or serum BuChE
- low CSF AcChE or serum AcChE
- high CSF ChAT or serum ChAT
- high CSF phenylalanine or serum phenylalanine
- low plasma leptin
- high serum homovanillic acid
- low serum acetylcholine
- low plasma esterase
- high CSF tyrosine or serum tyrosine
- high CSF methionine
- high CSF 5-HIAA
Related
delirium (acute confusional state)
General
risk factors for delirium
References
- Ormseth CH, LaHue SC, Oldham MA et al
Predisposing and Precipitating Factors Associated With Delirium.
A Systematic Review.
JAMA Netw Open. 2023;6(1):e2249950
PMID: 36607634
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800112