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

Heidi Lindroth*, Keibun Liu, Laura Szalacha, Shelly Ashkenazy, Giuseppe Bellelli, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabriel Heras-La-Calle, Magdalena Hoffman, Marie-Madlen Jeitziner, Karla Krewulak, Tanja Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S Oh, Marie Oxenboell Collet, Maria Carolina PaulinoRebecca von Haken, Peter Nydahl, WDAD Study Team

*Corresponding author af dette arbejde
12 Citationer (Scopus)

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.

OriginalsprogEngelsk
Artikelnummerafae248
TidsskriftAge and Ageing
Vol/bind53
Udgave nummer11
ISSN0002-0729
DOI
StatusUdgivet - 1 nov. 2024

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