Confused about delirium?

Nearly a third of elderly patients admitted to hospital in the UK have acute confusion, or delirium. A third of cases could be prevented by identifying those most at risk. Diagnosis is clinical and the best assessment tool is the confusion assessment method (CAM), according to this useful review. If a, b and either c or d are present, delirium is likely:

• a. Acute onset and fluctuating course during the day
• b. Inattention - easily distractible or difficulty keeping track of conversationc.
• c. Disorganised thinking - incoherent, rambling, or irrelevant conversation and unclear or illogical flow of ideasd.
• d. Altered consciousness - hyperalert, lethargic or drowsy, stuporous or comatose.

Source: Postgraduate Medical Journal 2009;85:405-413