Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day

Carly Welch; Lauren McCluskey; Daisy Wilson; George E. Chapman; Thomas A. Jackson; Jonathan Treml; Daniel Davis; Emma Cunningham; Claire Copeland; Terrence Quinn; Thomas Pinkney; Rahul Mahida; Peter Nightingale; Sarah Richardson; Oliver Todd; Ruth Willott; Kelli Torsney; Mary Ni Lochlainn; Kumudhini Giridharan; Natalie Cox; Jane Masoli; Lindsay Ronan; Victoria Gaunt; Benjamin Jelley; Joanne Taylor; Roisin Healy; Emily Rose; Megan Parkinson; Ajay MacHarouthu; Eilidh McKenzie; Roisin McCormack; Jasmine Hart; Alison McCulloch; Neil Henderson; Louise Beveridge; Emma Elliott; Bogna Drozdowska; Martin Taylor-Rowan; Natasha Christodoulides; James Allen; Harriet Brown; Jennifer Champion; Riana Patel; Ghazal Hodhody; Kara Mayor; Christopher James Miller; Mark Studley; Vishnu Prasad; Emma Mumtaz; Sam Cohen; Sherif Abdelbadiee; Anna Lewis; Bushra Khizar; Hannah Pendleton; Teresa Harkin; Steve Rutter; Ayoub Behbahani; Abolfazl Behbahani; Ani Tencheva; Rachel King; Laura Jones; Alex Hornsby; Robbie Horton; Kate Foster; Kirsty Moore; Vincent McCormack; Matthew Kearney; Emma Fisken; Rory Durcan; Elizabeth Deacon; Jane Noble; Arunkumar Annamalai; Roxana Taranu; Michael Sen; Pryankaran Mithrakumar; Laura Briggs; Jamal Bhatti; Shiv Bhakta; Amaka Achara; Elizabeth Ellis; Sejlo Koshedo; Ayesha Aamir; Edward Wu; Abdullah B. Khalid; Parrthiepan Visvaratnam; Ijeoma Obi; Nader Nashed; Chioma Iwu; Sneha Gurung; Shonit Nagumantry; Olugbenro Akintade; Valerie Page; Kwasi Debrah; Katie Ball; Jabed Ahmed; Zhao Xiao Bei; Sarah B. McClelland; Michael Haley; Norman Pang; Andre Le Poideven; Emily Moore; Freya Cooper; Natalie Grundmann; Elizabeth Lonsdale-Eccles; Janine Valentine; Emma Stratton; Emily Bowen; Miriam Thake; Dorothy Kuek; Wioletta Pyc; Deborah Scott; Frances Rickard; Natalie Gaskell; Helen McDonald; Victoria Gaent; Sam Mills; Stuart Winearls; Paapa A-Odame; Ciaran Barlow; Isabelle Nicholls; Emma Norman; Kim Kirrane; Peter Jackson; Christian Chourot; Laura Jayne Beeley; Aaron Kay; Victoria Clayton; John Marshall; Hannah Morgan; George Naish; Clare Hunt; Rajeev Mishra; Saurav Bhattacharya; Nisha Rai; Ahmad Alareed; Clementine Anderson; Ganapathy Bhat; Sandra Darko; Pedro Vila De Mucha; David Saliu; Karen Beharry; Laurence Caines; Sanojan Bremakumar; Daniel Furmedge; Celine Bultynck; Esther Hindley; Elaine Seymour; Darmiga Thayabaran; Cal Doherty; John Frewen; Oluwatosin O. Abiola; Simon Tetlow; Guy Tinson; Olivia Morrow; Isabel Greaves; Rachael Bygate; Aayenah Yunus; Catherine Bryant; Howell Jones; Helen Bowden; Rose Laud; Keziah Austin; Farrah Bahsoon; Martin Glasser; Khai Lee Cheah; James Speed; Lucy Porter; James Dove; Katrin Hoffman; Olivia Evans; Taran Nandra; Leeying Giet; Simon Stapley; Imola Bargaoanu; Ismail Kadir; Adam McClean; Pranav Mishra; Katie Houldershaw; Ana Andrusca; Emmy Abu; Adam Swietoslawski; Bilquis Ahmed; Matthew Ansell; Saad Abdullah; Shoaib Iqbal; James Wilcockson; Angela Kabia; Karthika Velusamy; Nihaad Syed; Charlotte Chuter; Hamza Ahmed; Sarah Ahmad; Gladys Ofoche; Jacqueline Ibanichuka; Alice Wheeler; Angharad Chilton; Zainab Hussain; Felicia Tan; Sinead Quinn; Paul Croft; Amy Walker; Charlotte Bell; Claire Wilkes; Eliza Griffiths; James Reid; Ahmed Abras; Muhammad Adam; Awolkhier Mohammedseid-Nurhussien; Sohail Shakeel; Zarah Amin; Georgia R. Layton; Nathan Ingamells; Jemima Taylor; Luke Wynne; Wan Idoracaera Calisa Ikhwan; Hanna Waraich; Olivia Cooper; Philip Thomas; Emily Williamson; Huma Naqvi; Helena Lee; Elizabeth Holmes; Megan Offer; Alex McQuillan; Emma Jay; Hannah Currie; Sureena Janagal; Gary Kumbun; Rodric Jenkin; Holly Jacques; James Gaywood; Laura Babb; Moe Su Su San; Sasha Porter-Bent; Daisy Wilson; Tarunya Vedutla; Asiodu Nneamaka; Anum Cheema; Hannah Moorey; Asma Khan; Zeinab Majid; Puja Jatti; Abhishek Gupta; Tammy Lee; Helen Chamberlain; Clare Hughes; Alexis Giles; Tamsin Critchlow; Bethan Morgan; Alice Moseley; Grace Fennelly; Sophie Pettler; Edward Bilton; Emma Astaire; William McKeown; Katherine Williamson; Caroline Rice; Sharan Ramakrishna; Zahid Subhan; Nedaa Haddad; Anjli Krishan

doi:10.1186/s12916-019-1458-7

Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day

Carly Welch, Lauren McCluskey, Daisy Wilson, George E. Chapman, Thomas A. Jackson, Jonathan Treml, Daniel Davis, Emma Cunningham, Claire Copeland, Terrence Quinn, Thomas Pinkney, Rahul Mahida, Peter Nightingale, Sarah Richardson, Oliver Todd, Ruth Willott, Kelli Torsney, Mary Ni Lochlainn, Kumudhini Giridharan, Natalie CoxJane Masoli, Lindsay Ronan, Victoria Gaunt, Benjamin Jelley, Joanne Taylor, Roisin Healy, Emily Rose, Megan Parkinson, Ajay MacHarouthu, Eilidh McKenzie, Roisin McCormack, Jasmine Hart, Alison McCulloch, Neil Henderson, Louise Beveridge, Emma Elliott, Bogna Drozdowska, Martin Taylor-Rowan, Natasha Christodoulides, James Allen, Harriet Brown, Jennifer Champion, Riana Patel, Ghazal Hodhody, Kara Mayor, Christopher James Miller, Mark Studley, Vishnu Prasad, Emma Mumtaz, Sam Cohen, Sherif Abdelbadiee, Anna Lewis, Bushra Khizar, Hannah Pendleton, Teresa Harkin, Steve Rutter, Ayoub Behbahani, Abolfazl Behbahani, Ani Tencheva, Rachel King, Laura Jones, Alex Hornsby, Robbie Horton, Kate Foster, Kirsty Moore, Vincent McCormack, Matthew Kearney, Emma Fisken, Rory Durcan, Elizabeth Deacon, Jane Noble, Arunkumar Annamalai, Roxana Taranu, Michael Sen, Pryankaran Mithrakumar, Laura Briggs, Jamal Bhatti, Shiv Bhakta, Amaka Achara, Elizabeth Ellis, Sejlo Koshedo, Ayesha Aamir, Edward Wu, Abdullah B. Khalid, Parrthiepan Visvaratnam, Ijeoma Obi, Nader Nashed, Chioma Iwu, Sneha Gurung, Shonit Nagumantry, Olugbenro Akintade, Valerie Page, Kwasi Debrah, Katie Ball, Jabed Ahmed, Zhao Xiao Bei, Sarah B. McClelland, Michael Haley, Norman Pang, Andre Le Poideven, Emily Moore, Freya Cooper, Natalie Grundmann, Elizabeth Lonsdale-Eccles, Janine Valentine, Emma Stratton, Emily Bowen, Miriam Thake, Dorothy Kuek, Wioletta Pyc, Deborah Scott, Frances Rickard, Natalie Gaskell, Helen McDonald, Victoria Gaent, Sam Mills, Stuart Winearls, Paapa A-Odame, Ciaran Barlow, Isabelle Nicholls, Emma Norman, Kim Kirrane, Peter Jackson, Christian Chourot, Laura Jayne Beeley, Aaron Kay, Victoria Clayton, John Marshall, Hannah Morgan, George Naish, Clare Hunt, Rajeev Mishra, Saurav Bhattacharya, Nisha Rai, Ahmad Alareed, Clementine Anderson, Ganapathy Bhat, Sandra Darko, Pedro Vila De Mucha, David Saliu, Karen Beharry, Laurence Caines, Sanojan Bremakumar, Daniel Furmedge, Celine Bultynck, Esther Hindley, Elaine Seymour, Darmiga Thayabaran, Cal Doherty, John Frewen, Oluwatosin O. Abiola, Simon Tetlow, Guy Tinson, Olivia Morrow, Isabel Greaves, Rachael Bygate, Aayenah Yunus, Catherine Bryant, Howell Jones, Helen Bowden, Rose Laud, Keziah Austin, Farrah Bahsoon, Martin Glasser, Khai Lee Cheah, James Speed, Lucy Porter, James Dove, Katrin Hoffman, Olivia Evans, Taran Nandra, Leeying Giet, Simon Stapley, Imola Bargaoanu, Ismail Kadir, Adam McClean, Pranav Mishra, Katie Houldershaw, Ana Andrusca, Emmy Abu, Adam Swietoslawski, Bilquis Ahmed, Matthew Ansell, Saad Abdullah, Shoaib Iqbal, James Wilcockson, Angela Kabia, Karthika Velusamy, Nihaad Syed, Charlotte Chuter, Hamza Ahmed, Sarah Ahmad, Gladys Ofoche, Jacqueline Ibanichuka, Alice Wheeler, Angharad Chilton, Zainab Hussain, Felicia Tan, Sinead Quinn, Paul Croft, Amy Walker, Charlotte Bell, Claire Wilkes, Eliza Griffiths, James Reid, Ahmed Abras, Muhammad Adam, Awolkhier Mohammedseid-Nurhussien, Sohail Shakeel, Zarah Amin, Georgia R. Layton, Nathan Ingamells, Jemima Taylor, Luke Wynne, Wan Idoracaera Calisa Ikhwan, Hanna Waraich, Olivia Cooper, Philip Thomas, Emily Williamson, Huma Naqvi, Helena Lee, Elizabeth Holmes, Megan Offer, Alex McQuillan, Emma Jay, Hannah Currie, Sureena Janagal, Gary Kumbun, Rodric Jenkin, Holly Jacques, James Gaywood, Laura Babb, Moe Su Su San, Sasha Porter-Bent, Daisy Wilson, Tarunya Vedutla, Asiodu Nneamaka, Anum Cheema, Hannah Moorey, Asma Khan, Zeinab Majid, Puja Jatti, Abhishek Gupta, Tammy Lee, Helen Chamberlain, Clare Hughes, Alexis Giles, Tamsin Critchlow, Bethan Morgan, Alice Moseley, Grace Fennelly, Sophie Pettler, Edward Bilton, Emma Astaire, William McKeown, Katherine Williamson, Caroline Rice, Sharan Ramakrishna, Zahid Subhan, Nedaa Haddad, Anjli Krishan

Research output: Contribution to journal › Article › peer-review

31 Citations (Scopus)

Abstract

Background: Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. Methods: We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. Results: The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4-6 (frail) (OR 4.80, CI 2.63-8.74), 7-9 (very frail) (OR 9.33, CI 4.79-18.17), compared to 1-3 (fit). However, higher CFS was associated with reduced delirium recognition (7-9 compared to 1-3; OR 0.16, CI 0.04-0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75-5.07) and increased mortality (OR 2.43, CI 1.44-4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67-11.21). Conclusions: Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.

Original language	English
Article number	229
Journal	BMC Medicine
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s12916-019-1458-7
Publication status	Published - 14 Dec 2019
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

Keywords

Collaboration
Delirium
Frailty
Older adults

Access to Document

10.1186/s12916-019-1458-7

Cite this

Welch, C., McCluskey, L., Wilson, D., Chapman, G. E., Jackson, T. A., Treml, J., Davis, D., Cunningham, E., Copeland, C., Quinn, T., Pinkney, T., Mahida, R., Nightingale, P., Richardson, S., Todd, O., Willott, R., Torsney, K., Ni Lochlainn, M., Giridharan, K., ... Krishan, A. (2019). Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day. BMC Medicine, 17(1), Article 229. https://doi.org/10.1186/s12916-019-1458-7

@article{7f5ae8239f4345b08c7153315b8a2b69,

title = "Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day",

abstract = "Background: Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. Methods: We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. Results: The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4-6 (frail) (OR 4.80, CI 2.63-8.74), 7-9 (very frail) (OR 9.33, CI 4.79-18.17), compared to 1-3 (fit). However, higher CFS was associated with reduced delirium recognition (7-9 compared to 1-3; OR 0.16, CI 0.04-0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75-5.07) and increased mortality (OR 2.43, CI 1.44-4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67-11.21). Conclusions: Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.",

keywords = "Collaboration, Delirium, Frailty, Older adults",

author = "Carly Welch and Lauren McCluskey and Daisy Wilson and Chapman, {George E.} and Jackson, {Thomas A.} and Jonathan Treml and Daniel Davis and Emma Cunningham and Claire Copeland and Terrence Quinn and Thomas Pinkney and Rahul Mahida and Peter Nightingale and Sarah Richardson and Oliver Todd and Ruth Willott and Kelli Torsney and {Ni Lochlainn}, Mary and Kumudhini Giridharan and Natalie Cox and Jane Masoli and Lindsay Ronan and Victoria Gaunt and Benjamin Jelley and Joanne Taylor and Roisin Healy and Emily Rose and Megan Parkinson and Ajay MacHarouthu and Eilidh McKenzie and Roisin McCormack and Jasmine Hart and Alison McCulloch and Neil Henderson and Louise Beveridge and Emma Elliott and Bogna Drozdowska and Martin Taylor-Rowan and Natasha Christodoulides and James Allen and Harriet Brown and Jennifer Champion and Riana Patel and Ghazal Hodhody and Kara Mayor and Miller, {Christopher James} and Mark Studley and Vishnu Prasad and Emma Mumtaz and Sam Cohen and Sherif Abdelbadiee and Anna Lewis and Bushra Khizar and Hannah Pendleton and Teresa Harkin and Steve Rutter and Ayoub Behbahani and Abolfazl Behbahani and Ani Tencheva and Rachel King and Laura Jones and Alex Hornsby and Robbie Horton and Kate Foster and Kirsty Moore and Vincent McCormack and Matthew Kearney and Emma Fisken and Rory Durcan and Elizabeth Deacon and Jane Noble and Arunkumar Annamalai and Roxana Taranu and Michael Sen and Pryankaran Mithrakumar and Laura Briggs and Jamal Bhatti and Shiv Bhakta and Amaka Achara and Elizabeth Ellis and Sejlo Koshedo and Ayesha Aamir and Edward Wu and Khalid, {Abdullah B.} and Parrthiepan Visvaratnam and Ijeoma Obi and Nader Nashed and Chioma Iwu and Sneha Gurung and Shonit Nagumantry and Olugbenro Akintade and Valerie Page and Kwasi Debrah and Katie Ball and Jabed Ahmed and Bei, {Zhao Xiao} and McClelland, {Sarah B.} and Michael Haley and Norman Pang and {Le Poideven}, Andre and Emily Moore and Freya Cooper and Natalie Grundmann and Elizabeth Lonsdale-Eccles and Janine Valentine and Emma Stratton and Emily Bowen and Miriam Thake and Dorothy Kuek and Wioletta Pyc and Deborah Scott and Frances Rickard and Natalie Gaskell and Helen McDonald and Victoria Gaent and Sam Mills and Stuart Winearls and Paapa A-Odame and Ciaran Barlow and Isabelle Nicholls and Emma Norman and Kim Kirrane and Peter Jackson and Christian Chourot and Beeley, {Laura Jayne} and Aaron Kay and Victoria Clayton and John Marshall and Hannah Morgan and George Naish and Clare Hunt and Rajeev Mishra and Saurav Bhattacharya and Nisha Rai and Ahmad Alareed and Clementine Anderson and Ganapathy Bhat and Sandra Darko and {Vila De Mucha}, Pedro and David Saliu and Karen Beharry and Laurence Caines and Sanojan Bremakumar and Daniel Furmedge and Celine Bultynck and Esther Hindley and Elaine Seymour and Darmiga Thayabaran and Cal Doherty and John Frewen and Abiola, {Oluwatosin O.} and Simon Tetlow and Guy Tinson and Olivia Morrow and Isabel Greaves and Rachael Bygate and Aayenah Yunus and Catherine Bryant and Howell Jones and Helen Bowden and Rose Laud and Keziah Austin and Farrah Bahsoon and Martin Glasser and Cheah, {Khai Lee} and James Speed and Lucy Porter and James Dove and Katrin Hoffman and Olivia Evans and Taran Nandra and Leeying Giet and Simon Stapley and Imola Bargaoanu and Ismail Kadir and Adam McClean and Pranav Mishra and Katie Houldershaw and Ana Andrusca and Emmy Abu and Adam Swietoslawski and Bilquis Ahmed and Matthew Ansell and Saad Abdullah and Shoaib Iqbal and James Wilcockson and Angela Kabia and Karthika Velusamy and Nihaad Syed and Charlotte Chuter and Hamza Ahmed and Sarah Ahmad and Gladys Ofoche and Jacqueline Ibanichuka and Alice Wheeler and Angharad Chilton and Zainab Hussain and Felicia Tan and Sinead Quinn and Paul Croft and Amy Walker and Charlotte Bell and Claire Wilkes and Eliza Griffiths and James Reid and Ahmed Abras and Muhammad Adam and Awolkhier Mohammedseid-Nurhussien and Sohail Shakeel and Zarah Amin and Layton, {Georgia R.} and Nathan Ingamells and Jemima Taylor and Luke Wynne and Ikhwan, {Wan Idoracaera Calisa} and Hanna Waraich and Olivia Cooper and Philip Thomas and Emily Williamson and Huma Naqvi and Helena Lee and Elizabeth Holmes and Megan Offer and Alex McQuillan and Emma Jay and Hannah Currie and Sureena Janagal and Gary Kumbun and Rodric Jenkin and Holly Jacques and James Gaywood and Laura Babb and San, {Moe Su Su} and Sasha Porter-Bent and Daisy Wilson and Tarunya Vedutla and Asiodu Nneamaka and Anum Cheema and Hannah Moorey and Asma Khan and Zeinab Majid and Puja Jatti and Abhishek Gupta and Tammy Lee and Helen Chamberlain and Clare Hughes and Alexis Giles and Tamsin Critchlow and Bethan Morgan and Alice Moseley and Grace Fennelly and Sophie Pettler and Edward Bilton and Emma Astaire and William McKeown and Katherine Williamson and Caroline Rice and Sharan Ramakrishna and Zahid Subhan and Nedaa Haddad and Anjli Krishan",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s).",

year = "2019",

month = dec,

day = "14",

doi = "10.1186/s12916-019-1458-7",

language = "English",

volume = "17",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central",

number = "1",

}

Welch, C, McCluskey, L, Wilson, D, Chapman, GE, Jackson, TA, Treml, J, Davis, D, Cunningham, E, Copeland, C, Quinn, T, Pinkney, T, Mahida, R, Nightingale, P, Richardson, S, Todd, O, Willott, R, Torsney, K, Ni Lochlainn, M, Giridharan, K, Cox, N, Masoli, J, Ronan, L, Gaunt, V, Jelley, B, Taylor, J, Healy, R, Rose, E, Parkinson, M, MacHarouthu, A, McKenzie, E, McCormack, R, Hart, J, McCulloch, A, Henderson, N, Beveridge, L, Elliott, E, Drozdowska, B, Taylor-Rowan, M, Christodoulides, N, Allen, J, Brown, H, Champion, J, Patel, R, Hodhody, G, Mayor, K, Miller, CJ, Studley, M, Prasad, V, Mumtaz, E, Cohen, S, Abdelbadiee, S, Lewis, A, Khizar, B, Pendleton, H, Harkin, T, Rutter, S, Behbahani, A, Behbahani, A, Tencheva, A, King, R, Jones, L, Hornsby, A, Horton, R, Foster, K, Moore, K, McCormack, V, Kearney, M, Fisken, E, Durcan, R, Deacon, E, Noble, J, Annamalai, A, Taranu, R, Sen, M, Mithrakumar, P, Briggs, L, Bhatti, J, Bhakta, S, Achara, A, Ellis, E, Koshedo, S, Aamir, A, Wu, E, Khalid, AB, Visvaratnam, P, Obi, I, Nashed, N, Iwu, C, Gurung, S, Nagumantry, S, Akintade, O, Page, V, Debrah, K, Ball, K, Ahmed, J, Bei, ZX, McClelland, SB, Haley, M, Pang, N, Le Poideven, A, Moore, E, Cooper, F, Grundmann, N, Lonsdale-Eccles, E, Valentine, J, Stratton, E, Bowen, E, Thake, M, Kuek, D, Pyc, W, Scott, D, Rickard, F, Gaskell, N, McDonald, H, Gaent, V, Mills, S, Winearls, S, A-Odame, P, Barlow, C, Nicholls, I, Norman, E, Kirrane, K, Jackson, P, Chourot, C, Beeley, LJ, Kay, A, Clayton, V, Marshall, J, Morgan, H, Naish, G, Hunt, C, Mishra, R, Bhattacharya, S, Rai, N, Alareed, A, Anderson, C, Bhat, G, Darko, S, Vila De Mucha, P, Saliu, D, Beharry, K, Caines, L, Bremakumar, S, Furmedge, D, Bultynck, C, Hindley, E, Seymour, E, Thayabaran, D, Doherty, C, Frewen, J, Abiola, OO, Tetlow, S, Tinson, G, Morrow, O, Greaves, I, Bygate, R, Yunus, A, Bryant, C, Jones, H, Bowden, H, Laud, R, Austin, K, Bahsoon, F, Glasser, M, Cheah, KL, Speed, J, Porter, L, Dove, J, Hoffman, K, Evans, O, Nandra, T, Giet, L, Stapley, S, Bargaoanu, I, Kadir, I, McClean, A, Mishra, P, Houldershaw, K, Andrusca, A, Abu, E, Swietoslawski, A, Ahmed, B, Ansell, M, Abdullah, S, Iqbal, S, Wilcockson, J, Kabia, A, Velusamy, K, Syed, N, Chuter, C, Ahmed, H, Ahmad, S, Ofoche, G, Ibanichuka, J, Wheeler, A, Chilton, A, Hussain, Z, Tan, F, Quinn, S, Croft, P, Walker, A, Bell, C, Wilkes, C, Griffiths, E, Reid, J, Abras, A, Adam, M, Mohammedseid-Nurhussien, A, Shakeel, S, Amin, Z, Layton, GR, Ingamells, N, Taylor, J, Wynne, L, Ikhwan, WIC, Waraich, H, Cooper, O, Thomas, P, Williamson, E, Naqvi, H, Lee, H, Holmes, E, Offer, M, McQuillan, A, Jay, E, Currie, H, Janagal, S, Kumbun, G, Jenkin, R, Jacques, H, Gaywood, J, Babb, L, San, MSS, Porter-Bent, S, Wilson, D, Vedutla, T, Nneamaka, A, Cheema, A, Moorey, H, Khan, A, Majid, Z, Jatti, P, Gupta, A, Lee, T, Chamberlain, H, Hughes, C, Giles, A, Critchlow, T, Morgan, B, Moseley, A, Fennelly, G, Pettler, S, Bilton, E, Astaire, E, McKeown, W, Williamson, K, Rice, C, Ramakrishna, S, Subhan, Z, Haddad, N & Krishan, A 2019, 'Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day', BMC Medicine, vol. 17, no. 1, 229. https://doi.org/10.1186/s12916-019-1458-7

TY - JOUR

T1 - Delirium is prevalent in older hospital inpatients and associated with adverse outcomes

T2 - Results of a prospective multi-centre study on World Delirium Awareness Day

AU - Welch, Carly

AU - McCluskey, Lauren

AU - Wilson, Daisy

AU - Chapman, George E.

AU - Jackson, Thomas A.

AU - Treml, Jonathan

AU - Davis, Daniel

AU - Cunningham, Emma

AU - Copeland, Claire

AU - Quinn, Terrence

AU - Pinkney, Thomas

AU - Mahida, Rahul

AU - Nightingale, Peter

AU - Richardson, Sarah

AU - Todd, Oliver

AU - Willott, Ruth

AU - Torsney, Kelli

AU - Ni Lochlainn, Mary

AU - Giridharan, Kumudhini

AU - Cox, Natalie

AU - Masoli, Jane

AU - Ronan, Lindsay

AU - Gaunt, Victoria

AU - Jelley, Benjamin

AU - Taylor, Joanne

AU - Healy, Roisin

AU - Rose, Emily

AU - Parkinson, Megan

AU - MacHarouthu, Ajay

AU - McKenzie, Eilidh

AU - McCormack, Roisin

AU - Hart, Jasmine

AU - McCulloch, Alison

AU - Henderson, Neil

AU - Beveridge, Louise

AU - Elliott, Emma

AU - Drozdowska, Bogna

AU - Taylor-Rowan, Martin

AU - Christodoulides, Natasha

AU - Allen, James

AU - Brown, Harriet

AU - Champion, Jennifer

AU - Patel, Riana

AU - Hodhody, Ghazal

AU - Mayor, Kara

AU - Miller, Christopher James

AU - Studley, Mark

AU - Prasad, Vishnu

AU - Mumtaz, Emma

AU - Cohen, Sam

AU - Abdelbadiee, Sherif

AU - Lewis, Anna

AU - Khizar, Bushra

AU - Pendleton, Hannah

AU - Harkin, Teresa

AU - Rutter, Steve

AU - Behbahani, Ayoub

AU - Behbahani, Abolfazl

AU - Tencheva, Ani

AU - King, Rachel

AU - Jones, Laura

AU - Hornsby, Alex

AU - Horton, Robbie

AU - Foster, Kate

AU - Moore, Kirsty

AU - McCormack, Vincent

AU - Kearney, Matthew

AU - Fisken, Emma

AU - Durcan, Rory

AU - Deacon, Elizabeth

AU - Noble, Jane

AU - Annamalai, Arunkumar

AU - Taranu, Roxana

AU - Sen, Michael

AU - Mithrakumar, Pryankaran

AU - Briggs, Laura

AU - Bhatti, Jamal

AU - Bhakta, Shiv

AU - Achara, Amaka

AU - Ellis, Elizabeth

AU - Koshedo, Sejlo

AU - Aamir, Ayesha

AU - Wu, Edward

AU - Khalid, Abdullah B.

AU - Visvaratnam, Parrthiepan

AU - Obi, Ijeoma

AU - Nashed, Nader

AU - Iwu, Chioma

AU - Gurung, Sneha

AU - Nagumantry, Shonit

AU - Akintade, Olugbenro

AU - Page, Valerie

AU - Debrah, Kwasi

AU - Ball, Katie

AU - Ahmed, Jabed

AU - Bei, Zhao Xiao

AU - McClelland, Sarah B.

AU - Haley, Michael

AU - Pang, Norman

AU - Le Poideven, Andre

AU - Moore, Emily

AU - Cooper, Freya

AU - Grundmann, Natalie

AU - Lonsdale-Eccles, Elizabeth

AU - Valentine, Janine

AU - Stratton, Emma

AU - Bowen, Emily

AU - Thake, Miriam

AU - Kuek, Dorothy

AU - Pyc, Wioletta

AU - Scott, Deborah

AU - Rickard, Frances

AU - Gaskell, Natalie

AU - McDonald, Helen

AU - Gaent, Victoria

AU - Mills, Sam

AU - Winearls, Stuart

AU - A-Odame, Paapa

AU - Barlow, Ciaran

AU - Nicholls, Isabelle

AU - Norman, Emma

AU - Kirrane, Kim

AU - Jackson, Peter

AU - Chourot, Christian

AU - Beeley, Laura Jayne

AU - Kay, Aaron

AU - Clayton, Victoria

AU - Marshall, John

AU - Morgan, Hannah

AU - Naish, George

AU - Hunt, Clare

AU - Mishra, Rajeev

AU - Bhattacharya, Saurav

AU - Rai, Nisha

AU - Alareed, Ahmad

AU - Anderson, Clementine

AU - Bhat, Ganapathy

AU - Darko, Sandra

AU - Vila De Mucha, Pedro

AU - Saliu, David

AU - Beharry, Karen

AU - Caines, Laurence

AU - Bremakumar, Sanojan

AU - Furmedge, Daniel

AU - Bultynck, Celine

AU - Hindley, Esther

AU - Seymour, Elaine

AU - Thayabaran, Darmiga

AU - Doherty, Cal

AU - Frewen, John

AU - Abiola, Oluwatosin O.

AU - Tetlow, Simon

AU - Tinson, Guy

AU - Morrow, Olivia

AU - Greaves, Isabel

AU - Bygate, Rachael

AU - Yunus, Aayenah

AU - Bryant, Catherine

AU - Jones, Howell

AU - Bowden, Helen

AU - Laud, Rose

AU - Austin, Keziah

AU - Bahsoon, Farrah

AU - Glasser, Martin

AU - Cheah, Khai Lee

AU - Speed, James

AU - Porter, Lucy

AU - Dove, James

AU - Hoffman, Katrin

AU - Evans, Olivia

AU - Nandra, Taran

AU - Giet, Leeying

AU - Stapley, Simon

AU - Bargaoanu, Imola

AU - Kadir, Ismail

AU - McClean, Adam

AU - Mishra, Pranav

AU - Houldershaw, Katie

AU - Andrusca, Ana

AU - Abu, Emmy

AU - Swietoslawski, Adam

AU - Ahmed, Bilquis

AU - Ansell, Matthew

AU - Abdullah, Saad

AU - Iqbal, Shoaib

AU - Wilcockson, James

AU - Kabia, Angela

AU - Velusamy, Karthika

AU - Syed, Nihaad

AU - Chuter, Charlotte

AU - Ahmed, Hamza

AU - Ahmad, Sarah

AU - Ofoche, Gladys

AU - Ibanichuka, Jacqueline

AU - Wheeler, Alice

AU - Chilton, Angharad

AU - Hussain, Zainab

AU - Tan, Felicia

AU - Quinn, Sinead

AU - Croft, Paul

AU - Walker, Amy

AU - Bell, Charlotte

AU - Wilkes, Claire

AU - Griffiths, Eliza

AU - Reid, James

AU - Abras, Ahmed

AU - Adam, Muhammad

AU - Mohammedseid-Nurhussien, Awolkhier

AU - Shakeel, Sohail

AU - Amin, Zarah

AU - Layton, Georgia R.

AU - Ingamells, Nathan

AU - Taylor, Jemima

AU - Wynne, Luke

AU - Ikhwan, Wan Idoracaera Calisa

AU - Waraich, Hanna

AU - Cooper, Olivia

AU - Thomas, Philip

AU - Williamson, Emily

AU - Naqvi, Huma

AU - Lee, Helena

AU - Holmes, Elizabeth

AU - Offer, Megan

AU - McQuillan, Alex

AU - Jay, Emma

AU - Currie, Hannah

AU - Janagal, Sureena

AU - Kumbun, Gary

AU - Jenkin, Rodric

AU - Jacques, Holly

AU - Gaywood, James

AU - Babb, Laura

AU - San, Moe Su Su

AU - Porter-Bent, Sasha

AU - Wilson, Daisy

AU - Vedutla, Tarunya

AU - Nneamaka, Asiodu

AU - Cheema, Anum

AU - Moorey, Hannah

AU - Khan, Asma

AU - Majid, Zeinab

AU - Jatti, Puja

AU - Gupta, Abhishek

AU - Lee, Tammy

AU - Chamberlain, Helen

AU - Hughes, Clare

AU - Giles, Alexis

AU - Critchlow, Tamsin

AU - Morgan, Bethan

AU - Moseley, Alice

AU - Fennelly, Grace

AU - Pettler, Sophie

AU - Bilton, Edward

AU - Astaire, Emma

AU - McKeown, William

AU - Williamson, Katherine

AU - Rice, Caroline

AU - Ramakrishna, Sharan

AU - Subhan, Zahid

AU - Haddad, Nedaa

AU - Krishan, Anjli

PY - 2019/12/14

Y1 - 2019/12/14

N2 - Background: Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. Methods: We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. Results: The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4-6 (frail) (OR 4.80, CI 2.63-8.74), 7-9 (very frail) (OR 9.33, CI 4.79-18.17), compared to 1-3 (fit). However, higher CFS was associated with reduced delirium recognition (7-9 compared to 1-3; OR 0.16, CI 0.04-0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75-5.07) and increased mortality (OR 2.43, CI 1.44-4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67-11.21). Conclusions: Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.

AB - Background: Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. Methods: We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. Results: The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4-6 (frail) (OR 4.80, CI 2.63-8.74), 7-9 (very frail) (OR 9.33, CI 4.79-18.17), compared to 1-3 (fit). However, higher CFS was associated with reduced delirium recognition (7-9 compared to 1-3; OR 0.16, CI 0.04-0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75-5.07) and increased mortality (OR 2.43, CI 1.44-4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67-11.21). Conclusions: Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.

KW - Collaboration

KW - Delirium

KW - Frailty

KW - Older adults

UR - http://www.scopus.com/inward/record.url?scp=85076709280&partnerID=8YFLogxK

U2 - 10.1186/s12916-019-1458-7

DO - 10.1186/s12916-019-1458-7

M3 - Article

C2 - 31837711

AN - SCOPUS:85076709280

SN - 1741-7015

VL - 17

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 229

ER -

Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: Results of a prospective multi-centre study on World Delirium Awareness Day

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