Delirium In ICU Patients Research Articles

Efficacy and safety of music therapy for the treatment of anxiety and delirium in ICU patients: a meta-analysis and systematic review of randomized controlled trials.

The medical application of music therapy (MT) has received widespread attention in recent years and some researchers have attempted to apply MT to the treatment of patients with anxiety and delirium in ICU. Relevant randomized controlled trials (randomized controlled trials s) were searched in databases, such as Web of Science, PubMed, Embase, Cochrane Library, Medline, Scopus, and CINAHL. Researchers performed literature screening, data extraction, literature quality assessment, and heterogeneity analysis among RCTs. Fourteen studies met the inclusion criteria. In general, we included RCTs with low risk of bias, and the primary outcome indicators, including the Chinese version of the State-Trait Anxiety Inventory (C-STAI), Visual Analogue Scale for Anxiety Measurement (VAS-A), and Facial Anxiety Scale (FAS), with a recommended level of evidence of "strong". The pooled results indicated that MT was effective in alleviating the anxiety state of ICU patients (95% CI, SMD=-1.09 [-1.52, -0.67], P<0.05) and could reduce mental and physical fatigue in patients with anxious delirium in ICU (95% CI, WMD=-2.35 [-3.37, -1.33], P <0.05). There were significant differences in the therapeutic effects of MT with different intervention durations. Both 15-minute and 30-minute MT were effective in reducing anxiety levels in patients with anxiety disorders in the ICU (15min: 95%CI, SMD=-1.70[-2.15, -1.24], P<0.05; 30min: 95%CI, SMD=-0.73[-1.16, - 0.29], P<0.05). However, when the duration of MT exceeded 45 min, the overtreatment of MT instead interfered with patient rest and failed to produce a positive therapeutic effect (95% CI, SMD=-1.04 [-3.06, 0.97], P=0.31). In addition, a meta-analysis of physiological outcomes found that MT was effective in maintaining the stabilization of heart rate (HR), respiratory rate (RR), and systolic blood pressure (SBP) in ICU patients with anxiety (P<0.05), but did not affect patients' oxygen saturation, mean arterial pressure and diastolic blood pressure (P>0.05). No adverse events occurred during MT treatment in the reports of included 14 studies. MT can safely and effectively reduce the anxiety level of patients with anxiety and delirium in ICU and relieve their psychological and physical fatigue. And MT was able to maintain the stability of HR, RR, and SBP in ICU patients.

Main features of diagnosis and treatment of delirium in icu patients: a systematic review

Relevance. Delirium is a severe neuropsychiatric syndrome, which is a common problem in patients in the intensive care unit (ICU). Recently published works indicate a insufficiency of awareness about the key principles of diagnosis and treatment of this condition. The aim of the study is to analyze and summarize data on algorithms that allow the identification and correction of delirium in patients in the intensive care unit. Materials and methods. A comprehensive search was conducted in the electronic databases PubMed and eLIBRARY. The review includes searchable publications for May 2023. Results. A literature review identified five adult delirium screening tools that have been validated against The Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic criteria for delirium. Prospects for improving clinical outcomes are multi-component programs with a large number of strategies aimed at assessing, preventing and treating delirium in the ICU. Conclusion. It is necessary to use validated screening tools, as well as implement preventive strategies such as ABCDEF. Prevention of delirium in the ICU by determining the level of risk, eliminating etiological development factors and early multimodal therapy should be included in the standard algorithm from the moment the patient is admitted to the hospital in order to reduce hospital mortality.

Prevalence of Delirium After Abdominal Surgery and Association With Ketamine: A Retrospective, Propensity-Matched Cohort Study.

Delirium is a common postoperative complication for older patients in the ICU. Ketamine, used primarily as an analgesic, has been thought to prevent delirium. Determine the prevalence and association of delirium with low-dose ketamine use in ICU patients after abdominal surgery. Single-center, retrospective, propensity-matched cohort study. Eight hospital academic medical center. Cohort comprising 1836 patients admitted to the ICU after abdominal surgery between June 23, 2018 and September 1, 2022. Propensity score matching (PSM) with a 3:1 ratio between no-ketamine use and ketamine use was performed through a greedy algorithm (caliper of 0.005). Outcomes of interest included: delirium (assessed by Confusion Assessment Method-ICU), mean pain score (Numeric Pain Scale or Critical Care Pain Observation Tool score as available), mean opioid consumption (morphine milligram equivalents), length of stay (d), and mortality. Prevalence of delirium was 47.71% (95% CI, 45.41-50.03%) in the cohort. Of 1836 patients, 120 (6.54%) used low-dose ketamine infusion. After PSM, the prevalence of delirium was 56.02% (95% CI, 51.05-60.91%) in all abdominal surgery patients. The ketamine group had 41% less odds of delirium (odds ratio [OR] = 0.59; 95% CI, 0.37-0.94; p = 0.026) than patients with no-ketamine use. Patients with ketamine use had higher mean pain scores (3.57 ± 2.86 vs. 2.21 ± 2.09, p < 0.001). In the subgroup analysis, patients in the ketamine-use group 60 years old or younger had 64% less odds of delirium (OR = 0.36; 95% CI, 0.13-0.95; p = 0.039). The mean pain scores were higher in the ketamine group for patients 60 years old or older. There was no significant difference in mortality and opioid consumption. Low-dose ketamine infusion was associated with lower prevalence of delirium in ICU patients following abdominal surgery. Prospective studies should further evaluate ketamine use and delirium.

Low Dose Risperidone Prophylaxis for The Prevention of Delirium in The Intensive Care Unit: A Randomized, Placebo Controlled Trial

Background Delirium is common among patients in intensive care units. Antipsychotics have been shown to reduce the incidence of delirium in post-operative patients. We set out to compare the efficacy of risperidone to placebo in preventing delirium in critically ill patients admitted to a medical ICU. Methods This double-blind, randomised controlled trial compared prophylactic low-dose risperidone to placebo in critically ill patients. Patients were screened daily for delirium using a validated screening tool (CAM-ICU), and the incidence of delirium was compared between groups. Results Forty-five patients were recruited. Baseline demographic characteristics, diagnosis and severity of illness were not statistically significantly different between groups. There was no significant difference in the incidence of delirium, adverse events or complications. Conclusion In this study, low-dose risperidone did not prevent the incidence of delirium. As delirium is a heterogeneous syndrome, a single intervention may not be effective across subtypes and aetiologies (ISRCTN17375500) Key Message Prophylactic risperidone did not reduce the incidence of delirium in ICU patients in this small study. As delirium is a heterogeneous syndrome, a single intervention may not be effective across subtypes and aetiologies.

The effect of nonpharmacological interventions applied by nurses to intensive care patients on the duration of delirium: a meta-analysis study.

It was aimed to determine the effect level of nonpharmacological methods applied by nurses to patients hospitalized in the intensive care unit on the duration of delirium. For this study, relevant studies were accessed by searching in July-October 2022. After the necessary exclusions were made, 14 studies were included in the study. The total sample size of the studies was 1123. According to the results, nonpharmacological interventions applied by nurses to intensive care patients were found to reduce the duration of delirium (SMD: - 0.625, 95% CI: - 1.1040-0.210; Z = - 2.950, p = 0.003, I2 = 93.119%). The country of the study (SMD: - 0.047, p = 0.001) and the types of nonpharmacological interventions used (SMD: - 0.062, p = 0.000) influenced the effect size of modulators on the duration of delirium in ICU patients. Nonpharmacological interventions applied by nurses, who have significant responsibilities in the protection and promotion of health, were found to reduce the duration of delirium in intensive care patients. This study shows that nurses, one of the main components of the multidisciplinary team in intensive care, are successful when they apply nonpharmacological interventions well.

Melatonin intervention to prevent delirium in the intensive care units: a systematic review and meta-analysis of randomized controlled trials.

To determine the preventive effect of melatonin on delirium in the intensive care units. We conducted a systematic search of the PubMed, Cochrane Library, Science, Embase, and CNKI databases, with retrieval dates ranging from the databases' inception to September 2022. Controlled trials on melatonin and placebo for preventing delirium in the intensive care units were included. The meta-analysis was performed using Review Manager software (version 5.3) and Stata software (version 14.0). Six studies involving 2374 patients were included in the meta-analysis. The results of the meta-analysis showed that melatonin did not reduce the incidence of delirium in ICU patients (odds ratio [OR]: 0.71; 95% confidence interval [CI]: 0.46 to 1.12; p = 0.14). There was a strong hetero-geneity between the selected studies (I2=74%). Subgroup analysis results showed that melatonin reduced the incidence of delirium in cardiovascular care unit (CCU) patients (OR: 0.52; 95% CI: 0.37 to 0.73; p=0.0001), but did not in general intensive care unit (GICU) patients (OR: 1.14; 95% CI: 0.86 to 1.50; p=0.35). In terms of the secondary outcomes, there were no significant differences in all-cause mortality (OR: 0.85; 95% CI: 0.66 to 1.09; p=0.20), length of ICU stay (mean difference [MD]: 0.33; 95% CI: -0.53 to 1.18; p=0.45), or length of hospital stay (MD: 0.51; 95% CI: -1.17 to 2.19; p=0.55). Melatonin reduced the incidence of delirium in CCU patients, but did not significantly reduce the incidence of delirium in GICU patients. https://www.crd.york.ac.uk/prospero/, identifier CRD42022367665.

Nurses' knowledge, barriers and practice in the care of patients with delirium in the intensive care unit in Poland-A cross-sectional study.

Delirium is a cognitive disorder that occurs with high frequency in patients in intensive care units and affects patient outcomes. Despite recommendations for monitoring and assessing delirium in the ICU, studies show that it is still not routinely assessed and often remains undiagnosed or misinterpreted as dementia or depression. The aim of this study was (1) to assess nurses' knowledge and clinical practices regarding delirium, (2) to identify the factors associated with nurses' knowledge, and (3) to define barriers to effective control of delirium. A cross-sectional study was conducted among 371 ICU nurses in Poland. 53.1% of nurses had never been educated on delirium control resulting in a deficit in knowledge of delirium symptoms, risk factors and complications associated with delirium in ICU patients. Master's degree in nursing (vs. Registered nurses + Bachelor's), female gender, and working in university hospital (vs. other) were positively correlated with nurse's knowledge, while age had a negative impact on knowledge. Delirium is a marginalized state in ICU patients, only 16.4% of nurses assessed delirium routinely and 35.8% assessed delirium occasionally, rarely using validated scales. Barriers to effective delirium control were primarily the lack of a requirement to assess delirium, the difficulty of assessing delirium in intubated patients and nurses' lack of confidence in their ability to use delirium assessment tools. There is an urgent need to educate nurses about delirium and to make delirium assessment obligatory in clinical practice. The area of change should also include a hospital policy on delirium monitoring and management. The study was registered on ClinicalTrials.gov (NCT05384964).

Deep Learning-Based Recurrent Delirium Prediction in Critically Ill Patients.

To predict impending delirium in ICU patients using recurrent deep learning. Retrospective cohort study. Fifteen medical-surgical ICUs across Alberta, Canada, between January 1, 2014, and January 24, 2020. Forty-three thousand five hundred ten ICU admissions from 38,426 patients. None. We used ICU and administrative health data to train deep learning models to predict delirium episodes in the next two 12-hour periods (0-12 and 12-24 hr), starting at 24 hours after ICU admission, and to generate new predictions every 12 hours. We used a comprehensive set of 3,643 features, capturing patient history, early ICU admission information (first 24 hr), and the temporal dynamics of various clinical variables throughout the ICU admission. Our deep learning architecture consisted of a feature embedding, a recurrent, and a prediction module. Our best model based on gated recurrent units yielded a sensitivity of 0.810, a specificity of 0.848, a precision (positive predictive value) of 0.704, and an area under the receiver operating characteristic curve (AUROC) of 0.909 in the hold-out test set for the 0-12-hour prediction horizon. For the 12-24-hour prediction horizon, the same model achieved a sensitivity of 0.791, a specificity of 0.807, a precision of 0.637, and an AUROC of 0.895 in the test set. Our delirium prediction model achieved strong performance by applying deep learning to a dataset that is at least one order of magnitude larger than those used in previous studies. Another novel aspect of our study is the temporal nature of our features and predictions. Our model enables accurate prediction of impending delirium in the ICU, which can potentially lead to early intervention, more efficient allocation of ICU resources, and improved patient outcomes.

Levetiracetam-associated behavioral adverse events in neurocritical care patients.

The objective of this study was to identify the incidence of levetiracetam-associated BAEs in NCC patients. Single-center retrospective cohort analysis. Patient charts. 965 adult ICU patients with a neurological injury receiving levetiracetam that were admitted to an intensive care unit. There were 965 patients included; 52% males with a median GCS of 13. Injury types included TBI (43.1%), ICH (21.8%), SAH (20.5%), and CI (14.6%). BAEs were identified in 46% of patients. Of these, 60% had documentation of agitation/restlessness, delirium, or anxiety while receiving levetiracetam, only 25% had a positive CAM-ICU, 13% had restraints ordered, and 42% received antipsychotics. Patients with TBI had the highest incidence of BAEs (52.4%). The median time to initiation of levetiracetam after hospital admission was 6.4 hours and BAEs occurred after 1.3 days of levetiracetam initiation. In this study, we found that almost half of our NCC population experienced levetiracetam associated BAEs which were mostly hyperactive in nature. We believe that the incidence of BAEs in our specific patient population cannot solely be attributed to ICU delirium given the lower risk of developing hyperactive delirium in ICU patients as compared to other subtypes. Therefore, monitoring and determination of the benefit versus risk in those experiencing BAEs is highly encouraged.

Non-pharmacological prevention and treatment of delirium in the intensive care unit

Delirium is an acute brain dysfunction that is a common and difficult-to-eliminate problem in the ICU. It is an important factor leading to prolonged hospital stay, increased treatment costs, and long-term cognitive impairment. Nonetheless, compared with the treatment of respiratory failure and its primary disease, the prevention and treatment measurements of delirium have not received enough attention, and its management strategies are still controversial. Evidence-based medicine currently does not support pharmacological approaches to preventing or treating delirium. Instead, it adopts a combination of multiple nonpharmacological methods to manage delirium in ICU patients through standardized evaluation and monitoring under the guidance of doctors and the cooperation of patients and their families.

Level of Delirium and its Contributing Factor among Patients in ICU

Background: Delirium is an acute state of confusion characterized by a rapid onset, usually within hours to days, with changes in consciousness and cognitive changes. Delirium may also present as a form of agitation in intensive care patients. Delirium can affect up to 80% of patients in intensive care units and increase their length of stay and cost of hospitalization. Objectives: The main aim of the study is to evaluate the level of Delirium and its contributing factors among patients in intensive care unit. Methods: A descriptive study design was adopted for the study with 60 samples that met the inclusion criteria and were selected using convenience sampling technique. Data for demographic variables were collected using multiple-choice questionnaires, followed by assessment of delirium using the Confusion Assessment Method (CAM) scale. Results: 20%) had mild delirium, 13 samples (21.7%) of moderate delirium and 13 samples (21.7%) of severe delirium. Regarding the demographic variables of delirium, diabetes rapidly had a statistically significant association with the degree of delirium in ICU patients at p &lt; 0.05. Conclusion: Confusion assessment method (CAM) is an effective to find out the level of delirium among intensive care unit patients.

External validation and comparison of two delirium prediction models in patients admitted to the cardiac intensive care unit.

BackgroundNo data is available on delirium prediction models in the cardiac intensive care unit (CICU), although preexisting delirium prediction models [PREdiction of DELIRium in ICu patients (PRE-DELIRIC) and Early PREdiction of DELIRium in ICu patients (E-PRE-DELIRIC)] were developed and validated based on a population admitted to the general intensive care unit (ICU). Therefore, we externally validated the usefulness of the PRE-DELIRIC and E-PRE-DELIRIC models and compared their predictive performance in patients admitted to the CICU.MethodsA total of 2,724 patients admitted to the CICU were enrolled between September 2012 and December 2018. Delirium was defined as at least one positive Confusion Assessment Method for the ICU (CAM-ICU) which was screened at least once every 8 h. The PRE-DELIRIC value was calculated within 24 h of CICU admission, and the E-PRE-DELIRIC value was calculated at CICU admission. The predictive performance of the models was evaluated by using the area under the receiver operating characteristic (AUROC) curve, and the calibration slope was assessed graphically by plotting.ResultsDelirium occurred in 677 patients (24.8%) when the patients were assessed thrice daily until 7 days of the CICU stay. The AUROC curve for the prediction of delirium was significantly greater for PRE-DELIRIC values [0.84, 95% confidence interval (CI): 0.82–0.86] than for E-PRE-DELIRIC values (0.79, 95% CI: 0.77–0.80) [z score of −6.24 (p < 0.001)]. Net reclassification improvement for the prediction of delirium increased by 0.27 (95% CI: 0.21–0.32, p < 0.001). Calibration was acceptable in the PRE-DELIRIC model (Hosmer-Lemeshow p = 0.170) but not in the E-PRE-DELIRIC model (Hosmer-Lemeshow p < 0.001).ConclusionAlthough both models have good predictive performance for the development of delirium, even in critically ill cardiac patients, the performance of the PRE-DELIRIC model might be superior to that of the E-PRE-DELIRIC model. Further studies are required to confirm our results and design a specific delirium prediction model for CICU patients.

ICU nurses’ perception, knowledge, and barriers on delirium assessment

Background and objective: Despite the availability of assessment tools for identifying and managing delirium in clinical settings, most cases remain undiagnosed, which demands the importance of conducting educational sessions. There is a necessity to understand why ICU nurses are unable to assess delirium in ICU patients, and there is a need to establish the best practice to promote patient safety. The descriptive cross-sectional research design aimed to assess the ICU nurses’ perception, knowledge, and Perceived barriers to delirium assessment, assess the association between qualifications and previous education regarding delirium to their knowledge and perception, and evaluate the association between ICU nurses' experience and total scores of knowledge and perception.Methods: A total 105 ICU nurses were selected from one of the tertiary hospitals in the Sultanate of Oman. Socio-demographics about ICU nurses’ knowledge, perception of delirium, and barriers to proper delirium assessment were collected by using an online self-administrative survey after obtaining consent. Data were statistically analyzed for central tendencies and level of dispersion (mean, range, and standard deviation).Results: The result of this study illustrated that 60.2% of ICU staff nurses have a moderate perception of the importance of delirium assessment in ICU. The majority of the nurses are females who held bachelor’s degrees with experience of six to ten years in the critical care field.Conclusions: The finding in this study illustrated that most of the staff nurses have previous training regarding delirium. However, there are gaps in delirium assessment, perception, and knowledge in ICU. Therefore, appropriate education is required to increase delirium identification, skill, and knowledge.

Delirium in ICU Patients after Cardiac Arrest: A Scoping Review.

Introduction: The incidence of delirium in the intensive care unit is high, although it may differ according to the specific characteristics of the unit. Despite the rapid development of research on delirium in recent years, the pathophysiological mechanisms leading to the clinical presentation of delirium are still subject to hypotheses. The aim of this review was to describe the incidence of delirium in cardiac arrest survivors and the clinical impact of delirium on patient outcomes. Methods: A scoping review was conducted in the second quarter of 2022. The number of articles retrieved during each search test was limited to studies conducted between 2010 and 2020. Strict inclusion and exclusion criteria were applied. The last search was conducted in May 2022. Results: A total of 537 records was initially obtained from the databases. After discarding duplicates, selecting titles and abstracts, and then analyzing full-text articles, 7 studies met the inclusion criteria. The incidence of delirium in the cardiac arrest survivor population ranged from 8% to as high as 100%. The length of stay in ICU and hospital was significantly longer in patients with delirium than those without. Ninety-eight percent of patients had cognitive or perceptual impairment and psychomotor impairment. Of the seven studies included in the analysis, the RASS, CAM, and NuDesc scales were used to diagnose delirium. Potential risk factors that may influence the duration of delirium include age and time since resuscitation; propofol use shortened the duration of delirium. Conclusion: the incidence of delirium in ICU patients who survived CA is high. Cardiac arrest is an additional predisposing factor for delirium. In cardiac arrest survivors, the occurrence of delirium prolongs the duration of ICU and hospital stay and adversely affects functional outcomes. The most common type of delirium among this population was hypoactive delirium. A large percentage of patients manifested symptoms such as cognitive or perception impairment, psychomotor impairment, and impaired concentration and attention.

Non-Pharmacological Nursing Interventions to Prevent Delirium in ICU Patients-An Umbrella Review with Implications for Evidence-Based Practice.

Delirium in ICU patients is a complication associated with many adverse consequences. Given the high prevalence of this complication in critically ill patients, it is essential to develop and implement an effective management protocol to prevent delirium. Given that the cause of delirium is multifactorial, non-pharmacological multicomponent interventions are promising strategies for delirium prevention. (1) Background: To identify and evaluate published systematic review on non-pharmacological nursing interventions to prevent delirium in intensive care unit patients. (2) Methods: An umbrella review guided by the Joanna Briggs Institute was utilized. Data were obtained from PubMed, Scopus, EBSCO, Web of Science, Cochrane Library, and Google Scholar. The last search was conducted on 1 May 2022. (3) Results: Fourteen reviews met the inclusion criteria. Multicomponent interventions are the most promising methods in the fight against delirium. The patient’s family is an important part of the process and should be included in the delirium prevention scheme. Light therapy can improve the patient’s circadian rhythm and thus contribute to reducing the incidence of delirium. (4) Conclusions: Non-pharmacological nursing interventions may be effective in preventing and reducing the duration of delirium in ICU patients.

Delirium in ICU patients: A syndrome ICU staff better not miss

Abstract not available Bangladesh Crit Care J March 2022; 10 (1): 7-9

Concise Definitive Review for Reinitiation of Antidepressants, Antipsychotics, and Gabapentinoids in ICU Patients.

Concise definitive review of the reinitiation of prior-to-admission neuropsychiatric medications (NPMs) in ICU patients. Available literature on PubMed and MEDLINE databases. Available clinical trials and observational studies addressing the reinitiation of select NPMs (antidepressants, antipsychotics, and gabapentinoids) on various outcomes were included. Eligible studies were identified by authors, and recommendations were summarized. Agitation and delirium are recognized as common complications of patients in the ICU. While there is literature that suggests patients can acutely withdraw from opioids, less data are known about withdrawal from NPM such as antidepressants, antipsychotics, and gabapentinoids. However, there is some literature that suggests reinitiating some NPMs may lead to reductions in agitation, delirium, and hospital and ICU length of stay. Additional larger studies are needed to evaluate the safety and efficacy of reinitiation of select prior-to-admission NPM to prevent agitation and delirium in ICU patients. Multiple factors for NPM reinitiation should be considered, such as reason for admission, organ dysfunction, available route of administration to provide prior-to-admission NPM, concomitant additional medications for agitation and delirium, and safety of these medications for patients in the ICU.

Influence of effective enteral nutrition support on delirium in ICU patients with mechanical ventilation

Abstract To evaluate the influence of effective enteral nutrition support on delirium in ICU patients with mechanical ventilation. 51 patients were divided into observation group and control group according to the nutrition support. Patients in the observation group received enteral nutritional support within 48h after mechanical ventilation. The mechanical ventilation time, duration of delirium, ICU length of hospital stay, lymphocyte number before and after the intervention, body weight, complications, and nutritional intervention time and nutritional standard time of patients in the two groups were evaluated and compared. There were 21 patients in control group, while 30 patients in observation group. The number of lymphocytes and body weight in the observation group were significantly higher than those in the control group (P < 0.05). The complication rate in the observation group was significantly lower than that in the control group (P < 0.05). The time of patients reaching the nutritional target in the observation group was significantly earlier than that in the control group (P < 0.05). The enteral nutritional support on ICU patients with mechanical ventilation is particularly effective, which effectively reduce the occurrence of delirium and other complications, thus improving the prognosis, which is of clinical application value.

Circadian Rhythm Disturbance and Delirium in ICU Patients: A Prospective Cohort Study

Circadian Rhythm Disturbance and Delirium in ICU Patients: A Prospective Cohort Study

Depression and anxiety increase the odds of developing delirium in ICU patients; a prospective observational study

ABSTRACT Background Delirium is prevalent among hospitalised patients, especially in critically ill patients. Preventing delirium by recognising its modifiable risk factors could improve life quality, decrease mortality and restrain its devastating consequences. Method We investigated 50 patients who had been hospitalised in the general ICU and monitored them for developing delirium. We employed CAM and CAM-ICU Scales to assess delirium, RASS score to determine the consciousness level, HADS questionnaire for anxiety and depression, and the demographic data questionnaire. Results We found that 20% of ICU patients developed delirium and found a meaningful correlation between the incident delirium, older ages, visual impairment, and higher anxiety and depression scores (HADS) of first and second days of hospitalisation. By utilising logistic regression, we found that older ages, visual impairment, higher anxiety and depression scores (HADS) of the first day of hospitalisation were statistically significant to predict the risk model of developing delirium. Conclusion Depressive and anxiety symptoms were associated with higher odds of transitioning to delirium; so, at the admission time, it may be useful to screen patients for the symptoms of affective disorders, particularly, who are at higher risks for developing delirium.