Delirium point prevalence studies in inpatient settings: A systematic review and meta-analysis

Binu Koirala, Bryan R. Hansen, Annmarie Hosie, Chakra Budhathoki, Stella Seal, Adam Beaman, Patricia M. Davidson

Research output: Contribution to journalReview articlepeer-review

Abstract

Aims: To examine the delirium point prevalence studies conducted in different inpatient settings and to discuss the implication of the findings for delirium screening, assessment, prevention and management. Background: Delirium—a common and distressing condition manifesting as an acute decline of attention and cognition—is frequently overlooked, misdiagnosed or treated inappropriately. This neuropsychiatric syndrome manifests as changes in attention, cognition and awareness, with resultant impact on behaviour, function and emotions. Delirium is recognised as a patient management challenge in the inpatient setting, and there is a need to understand the current point prevalence and assessment practices of delirium. Design: A systematic review and meta-analysis. Methods: A systematic review of published delirium prevalence studies in inpatient settings was conducted and the implications of findings for delirium screening, assessment, prevention and management identified. The random-effects meta-analysis was conducted among studies measuring delirium point prevalence. The PRISMA statement was used to report systematic review and meta-analysis. Results: Nine studies were included in the review, with sample sizes ranging from 47–1867. Delirium point prevalence ranged from 9%–32%. Hypoactive delirium was the most common subtype, ranging from 23%–78%. Fifteen delirium screening tools or assessment or diagnostic methods were used. Comorbid dementia was present in up to 50% of inpatients. Conclusions: Gaining a consensus on effective delirium instruments, the time windows for assessment and measurement will be crucial in driving benchmarking and quality improvement studies. Relevance to clinical practice: Consistent identification of high-risk patients and treatment settings with elevated risk, accompanied by the implementation of effective preventive and management strategies, are critical to addressing delirium—a frequent and burdensome condition, that adversely affects patient outcomes.

Original languageEnglish (US)
Pages (from-to)2083-2092
Number of pages10
JournalJournal of clinical nursing
Volume29
Issue number13-14
DOIs
StatePublished - Jul 1 2020

Keywords

  • delirium
  • inpatient
  • meta-analysis
  • point prevalence
  • systematic review

ASJC Scopus subject areas

  • Nursing(all)

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