Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep-Oct;65(5):417-430.
doi: 10.1016/j.jaclp.2024.06.005. Epub 2024 Jun 27.

Delirium in the United States: Results From the 2023 Cross-Sectional World Delirium Awareness Day Prevalence Study

Heidi Lindroth  1 , Tru Byrnes  2 , Mikita Fuchita  3 , Breanna Hetland  4 , Keibun Liu  5 , Kerri Maya  6 , Natalie S McAndrew  7 , Malissa A Mulkey  8 , Peter Nydahl  9 , Jessica Palakshappa  10 , Rebecca von Haken  11 , Kevin J Psoter  12 , Esther S Oh  13 ; U.S. WDAD Study Team
Collaborators, Affiliations

Delirium in the United States: Results From the 2023 Cross-Sectional World Delirium Awareness Day Prevalence Study

Heidi Lindroth et al. J Acad Consult Liaison Psychiatry. 2024 Sep-Oct.

Abstract

Background: Delirium is an acute brain dysfunction associated with an increased risk of mortality and future dementia.

Objectives: To describe the prevalence of clinically documented delirium in the United States on World Delirium Awareness Day 2023.

Methods: This is a sub-analysis of a prospective, cross-sectional, online, international survey. All health care settings were eligible, with the exception of operating rooms and outpatient clinics. Health care clinicians, administrators, and researchers completed the survey. The primary outcome was the prevalence of clinically documented delirium at 8:00 a.m. and 8:00 p.m. on March 15, 2023. Secondary outcomes were related to health care delivery. Descriptive statistics are reported. Differences between unit types (non-intensive care unit vs intensive care unit) were examined for all outcomes.

Results: Ninety-one hospital units reported on 1318/1213 patients. The prevalence of clinically documented delirium was 16.4% (n = 216/1318) at 8:00 a.m. and 17.9% (n = 217/1213) at 8:00 p.m. (P = 0.316) and significantly differed between age groups, reported discipline, unit, and hospital types. Significant differences were identified between non-intensive care unit and intensive care unit settings in the use of delirium-related protocols, nonpharmacologic and pharmacologic management, educational processes, and barriers to evidence-based delirium care.

Conclusions: To our knowledge, this is the first epidemiologic survey of clinically documented delirium across two time points in the United States. Delirium remains a significant burden and challenge for health care systems. The high percentage of units using delirium management protocols suggests administrator and clinician awareness of evidence-based strategies for its detection and mitigation. We provide recommendations for future studies and quality improvement projects to improve clinical recognition and management of delirium.

Keywords: clinical practice; delirium; health care system; prevalence; survey.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: H.L. serves on the American Delirium Society board of directors. She received a travel scholarship to present at the 2023 DECLARED Conference in Sydney, Australia, and payment for honoraria for keynote presentation on November 2022 from Parkview Health. She served as a consultant for Blue Agilis. She is a recipient of NIH/NIA funding. B.H. received an honorarium to present at annual conference of the American Association of Critical Care Nurses. In 2023, she received consulting fees of $8200 from Castner, Inc, for work she did it through the NIH I-Corps program. M.F. received a travel award to attend the 2023 Paul B. Beeson Annual Meeting from the American Federation for Aging Research and is supported by NIH funding. K.M. serves on the board of directors for the American Delirium Society. D.B. is supported by the Hopkins Health System. C.T. and L.B. received royalties for the edited books (“Manual of ICU Procedures” and “Textbook of Ventilation Fluids, Electrolytes and Blood Gases”) from the publisher Jaypee Brothers Medical Publishers (Pvt.) Ltd., New Delhi, and received financial support from the institute to attend the Annual Conferences of the Indian Society of Critical Care Medicine. J.P. received Career development award (NIH K23 AG072529). R.v.H received financial support from Orionpharma to attend ISICEM 2022 and holds leadership role at Netzwrek Delir eV. E.S.O. received grants from NIH/NIA, has a pending patent (#62/118887), was the President of the American Delirium Society 2022–2023, and receives funding from NIH. T.H. has leadership roles in the Academy of Consultation-Liaison Psychiatry and the Association of Medicine and Psychiatry. J. Popies serves as President of the Wisconsin Association of Clinical Nurse Specialists (unpaid).

References

    1. chap Neurocognitive Disorders. DSM Library Diagnostic and Statistical Manual of Mental Disorders-5. Diagnostic and Statistical Manual of Mental Disorders-5. Washington, DC: American Psychiatric Association; 2013
    1. Oldham MA, Holloway RG: Delirium disorder: integrating delirium and acute encephalopathy. Neurology 2020; 95:173–178 - PubMed
    1. Inouye SK, Westendorp RG, Saczynski JS: Delirium in elderly people. Lancet 2014; 383:911–922 - PMC - PubMed
    1. Hshieh TT, Inouye SK, Oh ES: Delirium in the elderly. Clin Geriatr Med 2020; 36:183–199 - PubMed
    1. Stollings JL, Kotfis K, Chanques G, Pun BT, Pandharipande PP, Ely EW: Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med 2021; 47:1089–1103 - PMC - PubMed