Point‐prevalence of delirium in intensive care units

Giraud, Kimberly; Vuylsteke, Alain

doi:10.1111/anae.12649

Cited by 6 publications

(8 citation statements)

References 9 publications

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“…In a recent point prevalence survey of nine ICUs in the UK, the incidence of delirium was 29 % in adult ICU patients. This study also confirmed that delirium screening practices in the UK remain inconsistent, which may account for the low incidence rates found [ 10 ]. Other reasons for a broad range in incidence figures could be differences in incidence in subspecialty ICUs, populations with variable severity of illness and under-recognition of the syndrome [ 11 , 12 ].…”

Section: Introductionsupporting

confidence: 82%

Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research

Bannon

McGaughey²,

Clarke

et al. 2016

Syst Rev

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BackgroundCritically ill patients have an increased risk of developing delirium during their intensive care stay. To date, pharmacological interventions have not been shown to be effective for delirium management but non-pharmacological interventions have shown some promise. The aim of this systematic review is to identify effective non-pharmacological interventions for reducing the incidence or the duration of delirium in critically ill patients.MethodsWe will search MEDLINE, EMBASE, CINAHL, Web of Science, AMED, psycINFO and the Cochrane Library. We will include studies of critically ill adults and children. We will include randomised trials and controlled trials which measure the effectiveness of one or more non-pharmacological interventions in reducing incidence or duration of delirium in critically ill patients. We will also include qualitative studies that provide an insight into patients and their families’ experiences of delirium and non-pharmacological interventions. Two independent reviewers will assess studies for eligibility, extract data and appraise quality. We will conduct meta-analyses if possible or present results narratively. Qualitative studies will also be reviewed by two independent reviewers, and a specially designed quality assessment tool incorporating the CASP framework and the POPAY framework will be used to assess quality.DiscussionAlthough non-pharmacological interventions have been studied in populations outside of intensive care units and multicomponent interventions have successfully reduced incidence and duration of delirium, no systematic review of non-pharmacological interventions specifically targeting delirium in critically ill patients have been undertaken to date. This systematic review will provide evidence for the development of a multicomponent intervention for delirium management of critically ill patients that can be tested in a subsequent multicentre randomised trial.Systematic review registrationPROSPERO CRD42015016625Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0254-0) contains supplementary material, which is available to authorized users.

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Section: Introductionsupporting

confidence: 82%

Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research

Bannon

McGaughey²,

Clarke

et al. 2016

Syst Rev

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“…Among the nine point prevalence studies included in the review, the majority were performed in a single country: Australia (Casey et al, ; Hosie et al, ), Denmark (Norbaek & Glipstrup, ), Ireland (Ryan et al, ), Italy (Bellelli et al, ), Scotland (Spiller & Keen, ) and UK (Giraud & Vuylsteke, ). One study (Elliott et al, ) included two countries: Australia and New Zealand; one study (Salluh et al, ) included 11 countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Spain, USA and Uruguay.…”

Section: Resultsmentioning

confidence: 99%

“…One study (Elliott et al, ) included two countries: Australia and New Zealand; one study (Salluh et al, ) included 11 countries: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Spain, USA and Uruguay. All studies focused on inpatient settings: ICU ( n = 3; Elliott et al, ; Giraud & Vuylsteke, ; Salluh et al, ); acute care hospital ( n = 4; Bellelli et al, ; Casey et al, ; Norbaek & Glipstrup, ; Ryan et al, ); and palliative care unit or hospice ( n = 2; Hosie et al, ; Spiller & Keen, ). The sample size for the selected studies ranged from 47–1,867 participants, who were primarily older adults with a reported mean age range of 61–82 years and 42%–63% male.…”

Section: Resultsmentioning

confidence: 99%

“…The Diagnostic and Statistical Manual of Mental Disorder criteria for delirium, DSM‐5 (Hosie et al, ) and DSM‐IV (Norbaek & Glipstrup, ; Ryan et al, ), were commonly used to assess delirium. The next most frequently used tools were as follows: the Confusion Assessment Method (CAM; Ryan et al, ; Spiller & Keen, ); the 4A Test—screening instrument for cognitive impairment and delirium (Bellelli et al, ; Casey et al, ); the Confusion Assessment Method for the ICU (CAM‐ICU; Giraud & Vuylsteke, ; Salluh et al, ); the 3‐Minute Diagnostic Interview for the Confusion Assessment Method (3D‐CAM; Casey et al, ); Brief Confusion Assessment Method (bCAM; Norbaek & Glipstrup, ); Clinical Assessment (Elliott et al, ); Delirium Rating Scale‐Revised‐98 (DRS‐R98), (Ryan et al, ); Delirium‐specific ICD codes (F05.0, F05.1, F05.8, F05.9; Casey et al, ); Intensive Care Delirium Screening Checklist (ICDSC; Elliott et al, ); Spatial Span Forwards (SSF), counting backwards from 20 was used for visually impaired patients (Ryan et al, ); Months Backwards (MB), adapted from the Short Blessed Test for dementia (Ryan et al, ); Nursing Delirium Screening Scale (Nu‐DESC; Hosie et al, ) and other (Elliott et al, ). Two assessment tools were used to identify delirium subtype—Memorial Delirium Assessment Scale (MDAS; Hosie et al, ; Spiller & Keen, ) and Delirium Motor Subtype Scale (DMSS; Bellelli et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…The delirium point prevalence ranged from 9%–34%. The time periods used to measure point prevalence varied—one day ( n = 4; Bellelli et al, ; Casey et al, ; Ryan et al, ; Salluh et al, ); two nonconsecutive days ( n = 2; Hosie et al, ; Norbaek & Glipstrup, ); two consecutive days ( n = 2; Casey et al, ; Spiller & Keen, ); three nonconsecutive days ( n = 1; Elliott et al, ); and seven days ( n = 1; Giraud & Vuylsteke, ).…”

Section: Resultsmentioning

confidence: 99%

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

Koirala

Hansen

Hosie

et al. 2020

Journal of Clinical Nursing

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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.

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Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings

Miranda,

Gonzalez,

Plana

et al. 2023

Cochrane Database of Systematic Reviews

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Point‐prevalence of delirium in intensive care units

Cited by 6 publications

References 9 publications

Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research

Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research

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

Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings

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