Precipitating risk factors in adults

The most commonly reported precipitants of delirium include:

• acute hip fracture
• acute organ failure—especially kidney failure, liver failure, and respiratory failure with hypoxia or hypercapnia
• cardiac events—for example, arrhythmias, heart failure and myocardial infarction
• constipation
• critical illness (ie intensive care support required)
• drugs—see Drugs and drug groups that commonly cause or contribute to delirium for drugs and drug groups that can cause or contribute to delirium
• hyperthyroidism and hypothyroidism
• infections—especially central nervous system infections, pneumonia, sepsis and urinary tract infections
• intracranial events—for example, intracerebral haemorrhage, seizures and postictal states, stroke and subarachnoid haemorrhage
• major surgery
• metabolic disturbances—for example, acidosis, alkalosis, hypercalcaemia, hyperglycaemia, hypoglycaemia, hypernatraemia and hyponatraemia
• pain and discomfort
• physical restraint
• withdrawal states—especially from alcohol and benzodiazepines
• urinary catheterisation and retention.