American Psychiatric Association Practice Guideline for the Prevention and Treatment of Delirium

"The prevalence rates of delirium range widely depending on the patient population and treatment setting. Delirium exacts a significant economic toll on individuals, their families, and society because of factors such as lengthy hospital stays, ICU admissions, rehospitalizations, and lost wages from work absenteeism. Both mortality and morbidity associated with delirium are substantial in many patient populations. Delirium has been linked to a host of deleterious outcomes and complications including more time spent on mechanical ventilation, increased odds of cognitive dysfunction, greater frailty and risk of falls, persistent functional decline, greater likelihood of discharge to long-term-care facilities rather than to home, increased risk of respiratory and neurological sequalae, and higher odds of difficult and extended extubation. Delirium can be a significant strain on patients and caregivers, due in part to subsequent psychosocial distress, such as anxiety and fear; high costs and health care use; and its association with conditions that are in and of themselves debilitating and burdensome to patients and caregivers, such as Alzheimer's dementia or end-stage diseases. The American Psychiatric Association Practice Guideline for the Prevention and Treatment of Delirium focuses on preventing the development of delirium in at-risk individuals and improving the quality of care and treatment outcomes for patients with delirium, thereby reducing the mortality, morbidity, and significant psychosocial and health consequences of this important psychiatric condition. This practice guideline focuses on evidence-based nonpharmacological and pharmacological interventions to prevent or treat delirium in adults. It also includes statements related to assessment and treatment planning, which are an integral part of patient-centered care. The scope of this document is shaped by the diagnostic criteria for delirium, with a particular focus on delirium as defined by DSM-5-TR"-