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Table 4.2

Causes of Delirium to Consider in Specific Patient Groups

Patient groupCommon causes
Older patient in emergency dept

Acute infection

Adverse effect of medication

Electrolyte disorder

Stroke

Subdural haematoma

Younger patient in emergency dept

Alcohol intoxication

Poisoning with cocaine, amphetamine and other psychoactive drugs

Primary neurological disorder (e.g. encephalitis)

Older patient with delirium after surgery

Acute infection

Adverse effect of medication

Urinary retention

Faecal impaction

Patient from psychiatric hospital

Neuroleptic malignant syndrome

Primary neurological disorder (e.g. encephalitis, brain tumour)

Patient with alcohol use disorder

Alcohol intoxication or withdrawal

Wernicke encephalopathy

Decompensated chronic liver disease

Acute infection (e.g. pneumonia, spontaneous bacterial peritonitis)

Patient with cancer

Adverse effect of medication (e.g. opioid toxicity)

Brain or meningeal metastases

Electrolyte disorder (e.g. hyponatraemia, hypercalcaemia)

Paraneoplastic effect

Reference: Oxford Clinical Diagnosis and Treatment eds Davey & Sprigings, OUP 2018. Reproduced with permission.