Mortality

The prognosis of delirium reflects its underlying cause. It is often the first sign of an impending medical disaster and is associated with increased disease severity and mortality. When delirium occurs, it should be treated as a potentially life-threatening emergency (C.E. Schwartz 1999). A confirmation of a diagnosis of delirium indicates a potentially grave prognosis, predicated more on the severity of the underlying medical condition than on the occurrence of delirium (van Hemert et al. 1994). Overall, mortality rates in children and adolescents with delirium (20%) (Turkel and Tavare 2003) are similar to rates in adults (20%-26%) (van Hemert et al. 1994).

The prevalence of delirium in medical and surgical settings has been documented to range between 10% and 50% and is as high as 80% in critically ill and postoperative patients (Eisendrath and Shim

2006). Delirium is an independent risk factor for increased mortality overall (Lacasse et al. 2006) and in mechanically ventilated patients in the ICU (Lin et al. 2004). It has been linked to increased length of stay (Schieveld et al. 2007) and morbidity and may adversely affect long-term outcomes (Eisendrath and Shim 2006). Children and adolescents with delirium may be at risk for persistent problems in cognition and behavior for up to 3 months (Prugh et al. 1980). In a study of pediatric patients in the ICU treated with either haloperidol or risperidone, 8% died of their underlying disorder, and delirium resolved in all the others (Schieveld et al. 2007).

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