Home › Research › Clinical safety
Delirium prevalence, diagnostic uncertainty and outcomes in ORCHARD-EPR: validation against prospective reference cohorts
Emily Louise Boucher, Jasmine Ming Gan, Nicola Georgia Lovett, S C L Smith, Sasha Shepperd, Sarah Tamsin Pendlebury. Age and Ageing, 2025-08-29
Topic: Risk, prevention and care in population studies
Among 18 614 ORCHARD-EPR patients (mean/SD age = 82.9/7.4 years, dementia = 20%), certain delirium (delirium = yes or ICD-10 delirium code) was present in 3077/18 614 (17%,95%CI 16%-17%) of whom 1199/3077 (39%) had dementia, and uncertain delirium (delirium = uncertain and no ICD-10 code) in 2007 (11%,10%-11%) of whom 773/2007 (39%) had dementia. In the prospective cohorts (n = 731, mean/SD age = 82.7/7.1 years, dementia = 21%), 277 (38%, 34%-42%, both P 0.1) but not comorbid dementia (SMD = 0.009) were more common in certain vs uncertain delirium. Excess mortality was similar in certain and uncertain delirium and the prospective cohorts. Delirium diagnostic uncertainty was frequent particularly in the absence of key delirium risk factors and delirium prevalence, even combining both certain and uncertain cases, was lower than in the prospective cohorts. Nevertheless, co-occurrence with dementia and outcomes were similar indicating validity of screening and research potential of ORCHARD-EPR.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Boucher, E. L., Gan, J. M., Lovett, N. G., Smith, S. C. L., Shepperd, S., & Pendlebury, S. T. (2025). Delirium prevalence, diagnostic uncertainty and outcomes in ORCHARD-EPR: validation against prospective reference cohorts. Age and Ageing. https://doi.org/10.1093/ageing/afaf284
Vancouver
Boucher EL, Gan JM, Lovett NG, Smith SCL, Shepperd S, Pendlebury ST. Delirium prevalence, diagnostic uncertainty and outcomes in ORCHARD-EPR: validation against prospective reference cohorts. Age and Ageing. 2025. doi:10.1093/ageing/afaf284. PMID: 41100407.
BibTeX
@article{boucher2025-41100407,
author = {Boucher, Emily Louise and Gan, Jasmine Ming and Lovett, Nicola Georgia and Smith, S C L and Shepperd, Sasha and Pendlebury, Sarah Tamsin},
title = {{Delirium prevalence, diagnostic uncertainty and outcomes in ORCHARD-EPR: validation against prospective reference cohorts}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf284},
pmid = {41100407},
url = {https://doi.org/10.1093/ageing/afaf284}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Among 18 614 ORCHARD-EPR patients (mean/SD age = 82.9/7.4 years, dementia = 20%), certain delirium (delirium = yes or ICD-10 delirium code) was present in 3077/18 614 (17%,95%CI 16%-17%) of whom 1199/3077 (39%) had dementia, and uncertain delirium (delirium = uncertain and no ICD-10 code) in 2007 (11%,10%-11%) of whom 773/2007 (39%) had dementia.
- In the prospective cohorts (n = 731, mean/SD age = 82.7/7.1 years, dementia = 21%), 277 (38%, 34%-42%, both P 0.1) but not comorbid dementia (SMD = 0.009) were more common in certain vs uncertain delirium.
- Excess mortality was similar in certain and uncertain delirium and the prospective cohorts.
- Delirium diagnostic uncertainty was frequent particularly in the absence of key delirium risk factors and delirium prevalence, even combining both certain and uncertain cases, was lower than in the prospective cohorts.
- Nevertheless, co-occurrence with dementia and outcomes were similar indicating validity of screening and research potential of ORCHARD-EPR.
Why it matters
This study checked whether a large electronic health record database could identify delirium cases accurately by comparing it with prospective reference groups. It found that uncertain delirium diagnoses were common and overall delirium prevalence was lower than in the prospective groups, but co-occurrence with dementia and outcomes were similar, suggesting the database has research potential.
Study details
- Participants731
- Evidence strengthLow
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (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 | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 731 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Sarah Tamsin Pendlebury: h-index 51 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41100407) |
| Free to read | 2 / 2 | Free to read |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
2 studies in the alzhub library list this one in their references.
Related studies in Clinical safety
Also tagged “palliative”
858 studies in the library carry the topic tag “palliative”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.