Delirium, brain dysfunction that is a side effect of critical illness and its treatments, affects about one-third of patients admitted to hospital intensive care units, says Dr. Christian Bime, medical director of the ICU at Banner-University Medical Center Tucson.
Patients in the ICU with untreated delirium have a two- to three-fold increased risk of dying within six months. They also are at higher risk for ending up in long-term care and having lasting cognitive problems similar to early Alzheimer’s disease or traumatic brain injury. People who are very old or very young are at highest risk, but it can occur at any age.
“It’s an independent marker for poor outcomes. It doesn’t just ride along with being sick,” says Dr. Mindy Fain, a geriatrician who is director of the University of Arizona’s Arizona Center on Aging.“It’s independently associated with death, complications in the hospital and discharge to a nursing home — all bad outcomes.
“If someone is in the hospital and they develop delirium, it means something else is going on and that is incumbent upon us to identify and treat it,” Fain says. “It is like a baby crying. It may be the only sign that something is wrong.”
Yet more than half of delirium in hospitals is missed, she says.