Refeeding syndrome as an iatrogenic cause of delirium: a retrospective pilot study

Psychosomatics. Sep-Oct 2010;51(5):419-24. doi: 10.1176/appi.psy.51.5.419.


Background: Refeeding syndrome describes a pattern of electrolyte disturbances occurring after the reintroduction of nutrition to the malnourished patient; it is often associated with delirium.

Objective: The authors investigated whether hospitalized elderly patients who develop delirium are more likely to have laboratory findings consistent with refeeding syndrome.

Method: The authors conducted a retrospective chart review of 100 patients over age 60. Charts were examined for indications of delirium and refeeding syndrome.

Results: Significantly lower serum levels of magnesium and phosphate were found in patients with delirium. Delirium was not associated with any significant difference in levels of potassium.

Conclusion: This study supports an association between delirium in elderly patients and electrolyte changes consistent with those seen in refeeding syndrome.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Delirium / etiology*
  • Female
  • Humans
  • Iatrogenic Disease
  • Magnesium / blood
  • Male
  • Middle Aged
  • Phosphates / blood
  • Pilot Projects
  • Refeeding Syndrome / complications*
  • Retrospective Studies
  • Statistics, Nonparametric
  • Water-Electrolyte Imbalance / complications*


  • Phosphates
  • Magnesium