References
Key articles
Devlin JW, Skrobik Y, Gélinas C, et al; American College of Critical Care Medicine. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018 Sep;46(9):e825-73.Full text Abstract
National Institute for Health and Care Excellence. Delirium: prevention, diagnosis and management in hospital and long-term care. Jan 2023 [internet publication].Full text Abstract
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022
Reference articles
1. Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73. Abstract
2. Devlin JW, Skrobik Y, Gélinas C, et al; American College of Critical Care Medicine. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018 Sep;46(9):e825-73.Full text Abstract
3. National Institute for Health and Care Excellence. Delirium: prevention, diagnosis and management in hospital and long-term care. Jan 2023 [internet publication].Full text Abstract
4. Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and intensive care medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol. 2024 Feb 1;41(2):81-108.Full text Abstract
5. Cole MG, Primeau FJ. Prognosis of delirium in elderly hospital patients. CMAJ. 1993 Jul 1;149(1):41-6. Abstract
6. Cavallazzi R, Saad M, Marik PE. Delirium in the ICU: an overview. Ann Intensive Care. 2012 Dec 27;2(1):49.Full text Abstract
7. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014 Mar 8;383(9920):911-22.Full text Abstract
8. Kiely DK, Bergmann MA, Murphy KM, et al. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci. 2003 May;58(5):441-5. Abstract
9. Murray AM, Levkoff SE, Wetle T, et al. Acute delirium and functional decline in the hospitalized elderly patient. J Gerontol. 1993 Sep;48(5):M181-6. Abstract
10. Marcantonio ER, Simon SE, Bergmann MA, et al. Delirium symptoms in post-acute care: prevalent, persistent, and associated with poor functional recovery. J Am Geriatr Soc. 2003 Jan;51(1):4-9. Abstract
11. van den Boogaard M, Schoonhoven L, Evers AW, et al. Delirium in critically ill patients: impact on long-term health-related quality of life and cognitive functioning. Crit Care Med. 2012 Jan;40(1):112-8. Abstract
12. Roche V. Southwestern Internal Medicine Conference. Etiology and management of delirium. Am J Med Sci. 2003 Jan;325(1):20-30. Abstract
13. Cole MG, Ciampi A, Belzile E, et al. Persistent delirium in older hospital patients: a systematic review of frequency and prognosis. Age Ageing. 2009 Jan;38(1):19-26.Full text Abstract
14. Goldberg TE, Chen C, Wang Y, et al. Association of delirium with long-term cognitive decline: a meta-analysis. JAMA Neurol. 2020 Nov 1;77(11):1373-81.Full text Abstract
15. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022
16. Potter J, George J; Guideline Development Group. The prevention, diagnosis and management of delirium in older people: concise guidelines. Clin Med. 2006 May-Jun;6(3):303-8. Abstract
17. Gupta N, de Jonghe J, Schieveld J, et al. Delirium phenomenology: what can we learn from the symptoms of delirium? J Psychosom Res. 2008 Sep;65(3):215-22. Abstract
18. Meagher DJ, Leonard M, Donnelly S, et al. A longitudinal study of motor subtypes in delirium: frequency and stability during episodes. J Psychosom Res. 2012 Mar;72(3):236-41. Abstract
20. US Department of Health and Human Services. 2004 CMS Statistics. Washington, DC: Centers for Medicare and Medicaid Services, 2004:34. (CMS Publication No 03445)
21. Ryan DJ, O'Regan NA, Caoimh RÓ, et al. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ Open. 2013 Jan 7;3(1):e001772.Full text Abstract
22. Neufeld KJ, Thomas C. Delirium: definition, epidemiology, and diagnosis. J Clin Neurophysiol. 2013 Oct;30(5):438-42. Abstract
23. Chen F, Liu L, Wang Y, et al. Delirium prevalence in geriatric emergency department patients: a systematic review and meta-analysis. Am J Emerg Med. 2022 Sep;59:121-8. Abstract
24. Wang Y, Dai M, Chen X, et al. Delirium prevalence in emergency department patients: a systematic review and meta-analysis. Nurs Crit Care. 2024 Nov;29(6):1215-23. Abstract
25. Xiao S , Davis JT . A G(4)·K(+) hydrogel made from 5'-hydrazinoguanosine for remediation of α,β-unsaturated carbonyls. Chem Commun (Camb). 2018 Oct 4;54(80):11300-3. Abstract
26. Gibb K, Seeley A, Quinn T, et al. The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study. Age Ageing. 2020 Apr 27;49(3):352-60.Full text Abstract
27. de Lange E, Verhaak PF, van der Meer K. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: a review. Int J Geriatr Psychiatry. 2013 Feb;28(2):127-34. Abstract
28. Singer GG, Brenner BM. Fluid and electrolyte disturbances. In: Kasper DL, Fauci AS, Longo DL, et al. eds. Harrison's Principles of Internal Medicine, 16th ed. New York, NY: McGraw Hill; 2005:252-63.
29. Choi SH, Lee H, Chung TS, et al. Neural network functional connectivity during and after an episode of delirium. Am J Psychiatry. 2012 May;169(5):498-507. Abstract
30. Trzepacz P, van der Mast R. The neuropathophysiology of delirium. In: Lindesay J, Rockwood K, Macdonald A, eds. Delirium in old age. Oxford, UK: Oxford University Press; 2002:51-90.
31. Cerejeira J, Nogueira V, Luís P, et al. The cholinergic system and inflammation: common pathways in delirium pathophysiology. J Am Geriatr Soc. 2012 Apr;60(4):669-75. Abstract
32. Oh ES, Needham DM, Nikooie R, et al. Antipsychotics for preventing delirium in hospitalized adults: a systematic review. Ann Intern Med. 2019 Oct 1;171(7):474-84.Full text Abstract
33. Janssen TL, Alberts AR, Hooft L, et al. Prevention of postoperative delirium in elderly patients planned for elective surgery: systematic review and meta-analysis. Clin Interv Aging. 2019;14:1095-117.Full text Abstract
34. Siddiqi N, Harrison JK, Clegg A, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2016 Mar 11;3:CD005563.Full text Abstract
35. Nikooie R, Neufeld KJ, Oh ES, et al. Antipsychotics for treating delirium in hospitalized adults: a systematic review. Ann Intern Med. 2019 Oct 1;171(7):485-95.Full text Abstract
36. Zayed Y, Barbarawi M, Kheiri B, et al. Haloperidol for the management of delirium in adult intensive care unit patients: a systematic review and meta-analysis of randomized controlled trials. J Crit Care. 2019 Apr;50:280-6.Full text Abstract
37. Burry L, Hutton B, Williamson DR, et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database Syst Rev. 2019 Sep 3;9:CD011749.Full text Abstract
38. Kishi T, Hirota T, Matsunaga S, et al. Antipsychotic medications for the treatment of delirium: a systematic review and meta-analysis of randomised controlled trials. J Neurol Neurosurg Psychiatry. 2016 Jul;87(7):767-74.Full text Abstract
39. Finucane AM, Jones L, Leurent B, et al. Drug therapy for delirium in terminally ill adults. Cochrane Database Syst Rev. 2020 Jan 21;1(1):CD004770.Full text Abstract
40. Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. The immunology of delirium. Neuroimmunomodulation. 2014;21(2-3):72-8. Abstract
41. Inouye SK. Delirium in older persons. N Engl J Med. 2006 Mar 16;354(11):1157-65. Abstract
42. Ormseth CH, LaHue SC, Oldham MA, et al. Predisposing and precipitating factors associated with delirium: a systematic review. JAMA Netw Open. 2023 Jan 3;6(1):e2249950.Full text Abstract
43. Khan BA, Zawahiri M, Campbell NL, et al. Delirium in hospitalized patients: implications of current evidence on clinical practice and future avenues for research - a systematic evidence review. J Hosp Med. 2012 Sep;7(7):580-9.Full text Abstract
44. Tow A, Holtzer R, Wang C, et al. Cognitive reserve and postoperative delirium in older adults. J Am Geriatr Soc. 2016 Jun;64(6):1341-6. Abstract
45. Leong AY, Edginton S, Lee LA, et al. The association between pain, analgesia, and delirium among critically ill adults: a systematic review and meta-analysis. Intensive Care Med. 2025 Feb;51(2):342-52. Abstract
46. White N, Bazo-Alvarez JC, Koopmans M, et al. Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis. Age Ageing. 2024 Apr 1;53(4):afae073.Full text Abstract
47. Rothberg MB, Herzig SJ, Pekow PS, et al. Association between sedating medications and delirium in older inpatients. J Am Geriatr Soc. 2013 Jun;61(6):923-30. Abstract
48. McPherson JA, Wagner CE, Boehm LM, et al. Delirium in the cardiovascular ICU: exploring modifiable risk factors. Crit Care Med. 2013 Feb;41(2):405-13. Abstract
49. Fox C, Smith T, Maidment I, et al. Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review. Age Ageing. 2014 Sep;43(5):604-15.Full text Abstract
50. Guenther U, Theuerkauf N, Frommann I, et al. Predisposing and precipitating factors of delirium after cardiac surgery: a prospective observational cohort study. Ann Surg. 2013 Jun;257(6):1160-7. Abstract
51. Slatore CG, Goy ER, OʼHearn DJ, et al. Sleep quality and its association with delirium among veterans enrolled in hospice. Am J Geriatr Psychiatry. 2012 Apr;20(4):317-26.Full text Abstract
52. Liu SW, Lee S, Hayes JM, et al. Head computed tomography findings in geriatric emergency department patients with delirium, altered mental status, and confusion: a systematic review. Acad Emerg Med. 2023 Jun;30(6):616-25.Full text Abstract
53. American College of Radiology. ACR appropriateness criteria: altered mental status, coma, delirium, and psychosis. 2024 [internet publication].Full text
54. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10.Full text Abstract
55. National Institute for Health and Care Excellence. Suspected sepsis: recognition, diagnosis and early management. Mar 2024 [internet publication].Full text
56. Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-143.Full text Abstract
57. Royal College of Physicians. National Early Warning Score (NEWS) 2. December 2017 [internet publication].Full text
58. American College of Emergency Physicians (ACEP) Expert Panel on Sepsis. DART: an evidence-driven tool to guide the early recognition and treatment of sepsis and septic shock [internet publication].Full text
59. Academy of Medical Royal Colleges. Statement on the initial antimicrobial treatment of sepsis. May 2022 [internet publication].Full text
60. Schlapbach LJ, Watson RS, Sorce LR, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024 Feb 27;331(8):665-74.Full text Abstract
61. Society of Critical Care Medicine. Surviving sepsis campaign: hour-1 bundle. 2019 [internet publication].Full text
62. van Meenen LC, van Meenen DM, de Rooij SE, et al. Risk prediction models for postoperative delirium: a systematic review and meta-analysis. J Am Geriatr Soc. 2014 Dec;62(12):2383-90. Abstract
63. Oh ES, Li M, Fafowora TM, et al. Preoperative risk factors for postoperative delirium following hip fracture repair: a systematic review. Int J Geriatr Psychiatry. 2015 Sep;30(9):900-10.Full text Abstract
64. Fortes-Filho SQ, Apolinario D, Melo JA, et al. Predicting delirium after hip fracture with a 2-min cognitive screen: prospective cohort study. Age Ageing. 2016 Sep;45(5):713-7. Abstract
65. Young J, Inouye SK. Delirium in older people. BMJ. 2007 Apr 21;334(7598):842-6. Abstract
66. Doriath V, Paesmans M, Catteau G et al. Acute confusion in patients with systemic cancer. J Neurooncol. 2007 Jul;83(3):285-9. Abstract
67. Leonard MM, Nekolaichuk C, Meagher DJ, et al. Practical assessment of delirium in palliative care. J Pain Symptom Manage. 2014 Aug;48(2):176-90. Abstract
68. Bush SH, Lawlor PG, Ryan K, et al. Delirium in adult cancer patients: ESMO clinical practice guidelines. Ann Oncol. 2018 Oct 1;29(suppl 4):iv143-65.Full text
69. Inouye SK, Foreman MD, Mion LC, et al. Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med. 2001 Nov 12;161(20):2467-73. Abstract
70. Registered Nurses Association of Ontario. Delirium, dementia, and depression in older adults: assessment and care, 2nd edition. 2016 [internet publication].Full text
71. Quispel-Aggenbach DWP, Holtman GA, Zwartjes HAHT, et al. Attention, arousal and other rapid bedside screening instruments for delirium in older patients: a systematic review of test accuracy studies. Age Ageing. 2018 Sep 1;47(5):644-653.Full text Abstract
72. National Institute for Health and Care Excellence. Dementia: assessment, management and support for people living with dementia and their carers. June 2018 [internet publication].Full text
73. Inouye SK, van Dyck CH, Alessi CA, et al. Clarifying confusion: the Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med. 1990 Dec 15;113(12):941-8. Abstract
74. Gusmao-Flores D, Salluh JI, Chalhub RA, et al. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care. 2012 Jul 3;16(4):R115.Full text Abstract
75. Hou L, Zhang Q, Cao L, et al. Diagnostic accuracy of the 4AT for delirium: a systematic review and meta-analysis. Asian J Psychiatr. 2023 Feb;80:103374. Abstract
76. Lin CJ, Su IC, Huang SW, et al. Delirium assessment tools among hospitalized older adults: a systematic review and metaanalysis of diagnostic accuracy. Ageing Res Rev. 2023 Sep;90:102025. Abstract
77. Miranda F, Gonzalez F, Plana MN, et al. Confusion assessment method for the intensive care unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings. Cochrane Database Syst Rev. 2023 Nov 21;11(11):CD013126.Full text Abstract
78. Carpenter CR, Lee S, Kennedy M, et al. Delirium detection in the emergency department: a diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments. Acad Emerg Med. 2024 Oct;31(10):1014-36. Abstract
79. Jones RN, Cizginer S, Pavlech L, et al. Assessment of instruments for measurement of delirium severity: a systematic review. JAMA Intern Med. 2019 Feb 1;179(2):231-9.Full text Abstract
80. Marcantonio ER, Ngo LH, O'Connor M, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study. Ann Intern Med. 2014 Oct 21;161(8):554-61.Full text Abstract
81. Ma R, Zhao J, Li C, et al. Diagnostic accuracy of the 3-minute diagnostic interview for confusion assessment method-defined delirium in delirium detection: a systematic review and meta-analysis. Age Ageing. 2023 May 1;52(5):afad074.Full text Abstract
82. Vasunilashorn SM, Guess J, Ngo L, et al. Derivation and validation of a severity scoring method for the 3-minute diagnostic interview for confusion assessment method - defined delirium. J Am Geriatr Soc. 2016 Aug;64(8):1684-9. Abstract
83. Inouye SK, Kosar CM, Tommet D, et al. The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Ann Intern Med. 2014 Apr 15;160(8):526-33. Abstract
84. Chen TJ, Chung YW, Chang HR, et al. Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: a bivariate meta-analysis. Int J Nurs Stud. 2021 Jan;113:103782.Full text Abstract
85. LaMantia MA, Messina FC, Hobgood CD, et al. Screening for delirium in the emergency department: a systematic review. Ann Emerg Med. 2014 May;63(5):551-60.Full text Abstract
86. Han JH, Wilson A, Graves AJ, et al. Validation of the confusion assessment method for the intensive care unit in older emergency department patients. Acad Emerg Med. 2014 Feb;21(2):180-7. Abstract
87. Han JH, Wilson A, Vasilevskis EE, et al. Diagnosing delirium in older emergency department patients: validity and reliability of the delirium triage screen and the brief confusion assessment method. Ann Emerg Med. 2013 Nov;62(5):457-65. Abstract
88. Morandi A, McCurley J, Vasilevskis EE, et al. Tools to detect delirium superimposed on dementia: a systematic review. J Am Geriatr Soc. 2012 Nov;60(11):2005-13. Abstract
89. Alagiakrishnan K, Wiens CA. An approach to drug induced delirium in the elderly. Postgrad Med J. 2004 Jul;80(945):388-93.Full text Abstract
90. Ceolin C, Papa MV, De Rui M, et al. Micronutrient deficiency and its potential role in delirium onset in older adults: a systematic review. J Nutr Health Aging. 2023;27(9):785-90.Full text Abstract
91. Carrasco MP, Villarroel L, Andrade M, et al. Development and validation of a delirium predictive score in older people. Age Ageing. 2014 May;43(3):346-51.Full text Abstract
92. Conaty O, Doherty AM, Lally J. Severe alprazolam withdrawal with delirium and psychosis: a case report and literature review. J Clin Psychopharmacol. 2023 Nov-Dec 01;43(6):511-3. Abstract
93. Neto AS, Nassar AP Jr, Cardoso SO, et al. Delirium screening in critically ill patients: a systematic review and meta-analysis. Crit Care Med. 2012 Jun;40(6):1946-51. Abstract
94. Devlin JW, Fong JJ, Fraser GL, et al. Delirium assessment in the critically ill. Intensive Care Med. 2007 Jun;33(6):929-40. Abstract
95. Van Rompaey B, Schuurmans MJ, Shortridge-Baggett LM, et al. Risk factors for intensive care delirium: a systematic review. Intensive Crit Care Nurs. 2008 Apr;24(2):98-107. Abstract
96. Van Den Boogaard MP. Assessment of delirium in ICU patients: a literature review. Neth J Crit Care. 2010 May;14(5):10-5.
97. Soiza RL, Sharma V, Ferguson K, et al. Neuroimaging studies of delirium: a systematic review. J Psychosom Res. 2008 Sep;65(3):239-48. Abstract
98. Sidhu KS, Balon R, Ajluni V, et al. Standard EEG and the difficult-to-assess mental status. Ann Clin Psychiatry. 2009 Apr-Jun;21(2):103-8. Abstract
99. Lavi R, Yarnitsky D, Rowe JM, et al. Standard vs atraumatic Whitacre needle for diagnostic lumbar puncture: a randomized trial. Neurology. 2006 Oct 24;67(8):1492-4. Abstract
100. Arendt K, Demaerschalk BM, Wingerchuk DM, Camann W. Atraumatic lumbar puncture needles: after all these years, are we still missing the point? Neurologist. 2009 Jan;15(1):17-20. Abstract
101. Nath S, Koziarz A, Badhiwala JH, et al. Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis. Lancet. 2018 Mar 24;391(10126):1197-204. Abstract
102. Rochwerg B, Almenawer SA, Siemieniuk RAC, et al. Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline. BMJ. 2018 May 22;361:k1920.Full text Abstract
103. Ahmed SV, Jayawarna C, Jude E. Post lumbar puncture headache: diagnosis and management. Postgrad Med J. 2006 Nov;82(973):713-6.Full text Abstract
104. Arevalo-Rodriguez I, Ciapponi A, Roqué i Figuls M, et al. Posture and fluids for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2016 Mar 7;(3):CD009199.Full text Abstract
105. Simundic AM, Bölenius K, Cadamuro J, et al. Joint EFLM-COLABIOCLI recommendation for venous blood sampling. Clin Chem Lab Med 2018;56(12):2015-38. Abstract
106. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011 May;7(3):263-9.Full text Abstract
107. Jack CR Jr, Andrews JS, Beach TG, et al. Revised criteria for diagnosis and staging of Alzheimer's disease: Alzheimer's association workgroup. Alzheimers Dement. 2024 Aug;20(8):5143-69.Full text Abstract
108. Abraham MB, Karges B, Dovc K, et al. ISPAD clinical practice consensus guidelines 2022: assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatr Diabetes. 2022 Dec;23(8):1322-40.Full text
109. Seaquist ER, Anderson J, Childs B, et al. Hypoglycemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care. 2013 May;36(5):1384-95.Full text Abstract
110. ElSayed NA, Aleppo G, Aroda VR, et al. 6. Glycemic targets: standards of care in diabetes-2023. Diabetes Care. 2023 Jan 1;46(suppl 1):S97-110.Full text Abstract
111. European Association for the Study of the Liver. EASL Clinical Practice Guidelines on the management of hepatic encephalopathy. J Hepatol. 2022 Sep;77(3):807-24.Full text Abstract
Use of this content is subject to our disclaimer