Risk factors for incident delirium in acute medical in-patients. A systematic review.

Abstract

Review question/objective What risk factors are associated with incident delirium in adult patients during an acute medical hospitalisation? More specifically, the objectives are to: Identify and synthesise the best available evidence on the factors which are associated with delirium in adult patients admitted to acute medical facilities. Types of participants This review will consider studies that include adults (defined as 18 years and above) who were admitted to an acute medical setting (e.g. general medical units, stroke units, short stay units and neuromedical units) who were not delirious on admission (in order to differentiate incident delirium) but who developed incident delirium during hospitalisation The review will exclude patients who were: - critically ill and admitted to specialist unit e.g. ICU or CCU - admitted for any type of surgery - admitted for alcohol related reasons - admitted to psychiatric facility These patients will be excluded in order to determine factors that may be exclusive to the medical in patient setting. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate any risk factors that may contribute to the development of delirium during in-patient hospitalisation. The review will look at factors present on admission (predisposing) and also factors that may occur during hospitalisation (precipitating) that contribute to incident delirium. Types of outcomes This review will consider studies that include the following outcome measures: the incidence of delirium as related to individual risk factors.