Delirium in the US: Results from 2023 cross-sectional World Delirium Awareness Day prevalence study

Lindroth H, Byrnes T, Fuchita M, Hetland B, Liu K, Maya K, McAndrew NS, Mulkey MA, Nydahl P, Palakshappa J, von Haken R, Psoter KJ, Oh ES; U.S. WDAD Study Team. JACLP DOI 10.1016/j.jaclp.2024.06.005

Introduction: Delirium is an acute physiological disruption of brain networks that manifests clinically as disorders of attention and cognition. These disorders fluctuate in severity, making accurate determinations of prevalence difficult within acutely hospitalized populations. Prevalence has been reported to range from 10-80% depending on the care setting and patient care population. Although delirium is often temporary and transient, it has negative short-term and long-term consequences. Delirium can compromise patient safety by increasing the risk of falls, aspiration events, and the use of physical and chemical restraints. Delirium is also associated with patient and caregiver distress, longer length of hospital stay, loss of function, decline in cognitive function, including incident dementia, and greater mortality. Altogether, delirium is estimated to cost over $164 billion annually in U.S. healthcare expenditures. Despite these adverse outcomes, delirium is frequently missed in clinical care, in part because there is limited use of validated delirium screening tools. Furthermore, there has been, and continues to be, inconsistent adoption of best practices to prevent and manage delirium.