Why do so few pcps diagnose the often permanenteffects of icu delirium after an icu stay? for three years, i described icu delirium symptoms to doctors but no one diagnosed it.

Not sure: They may have wanted to see symptoms in person before making a diagnosis. In other words, if you were the patient they may want independent verification. Just a thought.

Relatively new: For many years, patients in ICU were heavily sedated while on ventilators. This was second to keep them calm. We have learned relatively recently however that this is often detrimental and can result in confusion and brain dysfunction known as delirium. There have been studies in the last few years showing this can have longer term effects, as you know. Many pcps may be unaware of this.

Overlooked Diagnosis: Delirium and its symptoms are easily misinterpreted. It doesn't help that the most likely person to develop delirium is someone with dementia. And if the dementia is early it may not have been diagnosed until delirium occurs. At least one study suggests one needs to diagnose and treat delirium to resolution within the first 2 weeks to have the best chance of restoring function.

PCP not Intensivists: Icu psychosis or delirium is a disorder that is now more frequently recognized in older patients being treated in the icu. The causes are not completely understood and many protocols are being developed and tested in an attempt to reduce the incidence. Intensivists are just starting to learn more about it and primary care physicians will sonn be learning more about it as well.