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. 2024 Nov 1;53(11):afae248.
doi: 10.1093/ageing/afae248.

World delirium awareness and quality survey in 2023-a worldwide point prevalence study

Heidi Lindroth  1   2 , Keibun Liu  3   4   5 , Laura Szalacha  1   6 , Shelly Ashkenazy  7 , Giuseppe Bellelli  8   9 , Mark van den Boogaard  10 , Gideon Caplan  11   12 , Chi Ryang Chung  13 , Muhammed Elhadi  14 , Mohan Gurjar  15 , Gabriel Heras-La-Calle  16   17 , Magdalena Hoffman  18 , Marie-Madlen Jeitziner  19   20   21 , Karla Krewulak  22 , Tanja Mailhot  23 , Alessandro Morandi  24   25 , Ricardo Kenji Nawa  26 , Esther S Oh  27 , Marie Oxenboell Collet  28 , Maria Carolina Paulino  29   30   31 , Rebecca von Haken  32 , Peter Nydahl  33   34 ; WDAD Study Team
Affiliations

World delirium awareness and quality survey in 2023-a worldwide point prevalence study

Heidi Lindroth et al. Age Ageing. .

Abstract

Background: Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.

Objectives: To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.

Design: A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.

Participants: Clinicians or researchers with access to clinical data.

Main outcome and measure: The primary outcome was the prevalence of clinically documented delirium at 8:00 a.m. (4 h) and 8:00 p.m. (±4 h). Secondary outcomes included delirium-related care practices and barriers to use. Descriptive statistics were calculated and multilevel modelling was completed.

Results: 1664 wards submitted surveys from 44 countries, reporting on delirium assessments at 8:00 a.m. (n = 36 048) and 8:00 p.m. (n = 32 867); 61% reported use of validated delirium assessment tools. At 8:00 a.m., 18% (n = 2788/15 458) and at 8:00 p.m., 17.7% (n = 2454/13 860) were delirium positive. Top prevention measures were pain management (86.7%), mobilisation (81.4%) and adequate fluids (80.4%). Frequently reported pharmacologic interventions were benzodiazepines (52.7%) and haloperidol (46.2%). Top barriers included the shortage of staff (54.3%), lack of time to educate staff (48.6%) and missing knowledge about delirium (38%).

Conclusion and relevance: In this study, approximately one out of five patients were reported as delirious. The reported high use of benzodiazepines needs further evaluation as it is not aligned with best-practice recommendations. Findings provide a benchmark for future quality improvement projects and research.

Keywords: cross-sectional studies; delivery of health care; global delirium prevalence; older people; standard of practice.

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Conflict of interest statement

H.L. is funded by the NIA 1AGK23076662-02, serves as a board member for the American Delirium Society and was the 2023 conference co-chair for the American Delirium Society, and serves as the web committee chair for the American Thoracic Society, Nursing Assembly. She has received royalties for keynote addresses at nursing conferences in 2022 and received a travel scholarship to attend the 2023 DECLARED conference in Sydney, Australia and the 2024 Hunters Geriatrics Conference in Newcastle, Australia. G.C. is the Past President of the Australian Delirium Association. M.G. has received royalties for the edited books (Manual of ICU Procedures, Textbook of Ventilation Fluids, Electrolytes, and Blood Gases) from the publisher Jaypee Brothers Medical Publishers and has received financial support to attend the Annual Conference of Indian Society of Critical Care Medicine. G.H.C. has spoke on Humanization of Healthcare (Pfizer) and was supported by Pfizer to attend the COMMEC 2022 meeting. E.S.O. is supported by NIH/NIA funding (unrelated to this manuscript), received honoraria to present at the Edmund Beacham Annual Current Topics in Geriatrics, has patents issued or pending, and was the 2022 President of the American Delirium Society. M.O.C. received funding unrelated to this manuscript from Novo Fonden, Lundbeck Funden and Dagmar Marshells Fond. R.V.H. received support from OrionPharma to attend meetings and/or travel.

Figures

Figure 1
Figure 1
Surveys completed worldwide. Figure 1 illustrates the surveys completed per country and per continent. The numbers represent the total number of wards/units (bold) and total number of patients (in brackets). The grey-scale colour of the countries indicates the number of responses; a darker grey colour represents a high number of surveys received.
See this image and copyright information in PMC

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