Models for Predicting Incident Delirium in Hospitalized Older Adults: A Systematic Review

Abstract

Purpose: The purpose of this systematic review is to summarize the reported risk prediction models and identify the most prevalent factors for incident delirium in older inpatient populations (age ≥ 65 years). In the future, these risk factors could be used to develop a delirium risk prediction model in the electronic health record that can be used by the Hospital Elder Life Program to reduce the incidence of delirium. Methods: A medical librarian customized and conducted a search strategy for all published articles on delirium prediction models using an array of electronic databases and specific inclusion and exclusion criteria. Then, a geriatrician and two research associates assessed the quality of the selected studies using the Newcastle-Ottawa Scale (NOS). Results: A total of 4,351 articles were identified from initial literature search. After review, data were extracted from 12 studies. The quality of these studies was assessed using NOS and ranged from 4 to 8. The most common risk factors reported were dementia, decreased functional status, high blood urea nitrogen-to-creatinine ratio, infection and severe illness. Conclusions: The most prevalent factors associated with incidence of delirium in hospitalized older patients identified by this systematic review could be used to develop an electronic health record-generated risk prediction model to identify inpatients at risk of developing delirium.

Keywords

• incidence
• delirium
• Hospital Elder Life Program
• inpatient
• hospitalized older adults
• cognitive impairment
• altered mental status
• risk factors