+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Persistent delirium in older hospital patients: a systematic review of frequency and prognosis

Persistent delirium in older hospital patients: a systematic review of frequency and prognosis

Age and Ageing 38(1): 19-26

one explanation for the poor prognosis of delirium among older hospital patients may be that many of these patients do not recover from delirium. We sought to determine the frequency and prognosis of persistent delirium (PerD) in older hospital patients by systematically reviewing original research on this topic. MEDLINE, EMBASE, PsycINFO and the Cochrane Database of Systematic Reviews were searched for potentially relevant articles. The bibliographies of relevant articles were searched for additional references. Eighteen reports (involving 1,322 patients with delirium) met the following seven inclusion criteria: original research published in English or French, prospective study design, study population of at least 20 hospital patients, patients aged 50 years or more, follow-up of at least 1 week, acceptable definition of delirium at enrollment and included at least one assessment for PerD at discharge or later. The methods of each study were assessed according to the six criteria for prognostic studies described by the Evidence-Based Medicine Working Group. Information about the sample origin and size, age, proportion with dementia, criteria for delirium, timing of follow-up assessments, criteria for PerD, proportion with PerD and prognosis of PerD was systematically abstracted from each report, tabulated and combined using standard meta-analysis techniques. the combined proportions with PerD at discharge, 1, 3 and 6 months were 44.7% (95% CI 26.8%, 63.7%), 32.8% (95% CI 18.4%, 47.2%), 25.6% (95% CI 7.9%, 43.4%) and 21% (95% CI 1.4%, 40.6%), respectively. The outcomes (mortality, nursing home placement, function, cognition) of patients with PerD were consistently worse than the outcomes of patients who had recovered from delirium. PerD in older hospital patients is frequent, appears to be associated with adverse outcomes and may account for the poor prognosis of delirium in this population. These findings have potentially important implications for clinical practice and research.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 054944106

Download citation: RISBibTeXText

PMID: 19017678

DOI: 10.1093/ageing/afn253

Related references

Predicting outcome in older hospital patients with delirium: a systematic literature review. International Journal of Geriatric Psychiatry 31(4): 392-399, 2015

Persistent delirium in older hospital patients. Current Opinion in Psychiatry 23(3): 250-254, 2011

Prognosis after hospital discharge of older medical patients with delirium. Journal of the American Geriatrics Society 40(6): 601-606, 1992

Subsyndromal delirium in older people: a systematic review of frequency, risk factors, course and outcomes. International Journal of Geriatric Psychiatry 28(8): 771-780, 2014

Risk factors for incident delirium among older people in acute hospital medical units: a systematic review and meta-analysis. Age and Ageing 43(3): 326-333, 2014

Effectiveness of multicomponent interventions on incidence of delirium in hospitalized older patients with hip fracture: a systematic review. International Psychogeriatrics 30(4): 481-492, 2018

Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: a systematic review. International Journal of Geriatric Psychiatry 31(9): 974-989, 2016

Systematic review of antipsychotics for the treatment of hospital-associated delirium in medically or surgically ill patients. Annals of PharmacoTherapy 40(11): 1966-1973, 2006

Effectiveness of multi-component interventions on incidence of delirium in hospitalized older patients with hip fracture: a systematic review protocol. Jbi Database of Systematic Reviews and Implementation Reports 15(2): 259-268, 2018

Systematic review and meta-analysis of risk factors for postoperative delirium among older patients undergoing gastrointestinal surgery. British Journal of Surgery 103(2): E21-E28, 2016

Attention, arousal and other rapid bedside screening instruments for delirium in older patients: a systematic review of test accuracy studies. Age and Ageing: -, 2018

Experiences, understandings and support needs of family carers of older patients with delirium: a descriptive mixed methods study in a hospital delirium unit. International Journal of Older People Nursing 9(3): 200-208, 2015

The prognosis of depression in older patients in general practice and the community. A systematic review. Family Practice 24(2): 168-180, 2007

Systematic review of how to stop smoking in pregnancy and following childbirth; The experience of living with chronic manifestations of lymphatic filariasis among patients 15 years and older in developing countries: a systematic review; Utilization of theoretical models and frameworks in the process of evidence synthesis: scoping review; The effectiveness of sitz bath in managing adult patients with anorectal disorders: a systematic review. Journal of Advanced Nursing 66(12): 2620-2626, 2010

The use of volunteers to help older medical patients mobilise in hospital: a systematic review. Journal of Clinical Nursing 25(21-22): 3102-3112, 2016