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A prospective study of delirium in hospitalized elderly
Francis J, Martin D, Kapoor WN.. JAMA, 1990-02-01
Topic: Risk, prevention and care in population studies
The prevalence, risk factors, and outcomes of delirium were studied in 229 elderly patients. Fifty patients (22%) met criteria for delirium; nondelirious elderly constituted the control group. Abnormal sodium levels, illness severity, dementia, fever or hypothermia, psychoactive drug use, and azotemia were associated with risk of delirium. Patients with three or more risk factors had a 60% rate of delirium. Delirious patients stayed 12.1 days in the hospital vs 7.2 days for controls and were more likely to die (8% vs 1%) or be institutionalized (16% vs 3%). Illness severity predicted 6-month mortality, but the effect of delirium was not significant. Delirium occurs commonly in hospitalized elderly, is associated with chronic and acute problems, and identifies elderly at risk for death, longer hospitalization, and institutionalization. The increased mortality associated with delirium appears to be explained by greater severity of illness.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Francis, J., Martin, D., & Kapoor, W. N. (1990). A prospective study of delirium in hospitalized elderly. JAMA. https://doi.org/10.1001/jama.1990.03440080075027
Vancouver
Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA. 1990. doi:10.1001/jama.1990.03440080075027. PMID: 2299782.
BibTeX
@article{francis1990-2299782,
author = {Francis, J. and Martin, D. and Kapoor, W. N.},
title = {{A prospective study of delirium in hospitalized elderly}},
journal = {JAMA},
year = {1990},
doi = {10.1001/jama.1990.03440080075027},
pmid = {2299782},
url = {https://doi.org/10.1001/jama.1990.03440080075027}
}
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Key findings
- Abnormal sodium levels, illness severity, dementia, fever or hypothermia, psychoactive drug use, and azotemia were associated with risk of delirium.
- Illness severity predicted 6-month mortality, but the effect of delirium was not significant.
- Delirium occurs commonly in hospitalized elderly, is associated with chronic and acute problems, and identifies elderly at risk for death, longer hospitalization, and institutionalization.
- The increased mortality associated with delirium appears to be explained by greater severity of illness.
Why it matters
Delirium was common in hospitalized elderly patients and was linked to longer hospital stays, death, and institutionalization. However, the study found that the effect of delirium on 6-month mortality was not significant and appeared explained by greater severity of illness.
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Study details
- Evidence strengthLow
How this study scored 49/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 47 of the 96 points we could judge it on, which is 49 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1990 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 888 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 23.4 citations a year over 38 year(s) since 1990 |
| Impact for its field and year | 4 / 6 | Cited 17.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 2 / 4 | Cited 19 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 1 / 3 | University of Pittsburgh: institution h-index 1,470 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2299782) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 47 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 47 of the 96 points we could judge it on is 49 out of 100. |
| Total | 49 / 100 | — |
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