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The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study
Gibb K, Seeley A, Quinn T, Siddiqi N, Shenkin S, Rockwood K, Davis D.. Age and ageing, 2020-04-01
Topic: Risk, prevention and care in population studies
Introduction Delirium is associated with a wide range of adverse patient safety outcomes, yet it remains consistently under-diagnosed. We undertook a systematic review of studies describing delirium in adult medical patients in secondary care. We investigated if changes in healthcare complexity were associated with trends in reported delirium over the last four decades. Methods We used identical criteria to a previous systematic review, only including studies using internationally accepted diagnostic criteria for delirium (the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases). Estimates were pooled across studies using random effects meta-analysis, and we estimated temporal changes using meta-regression. We investigated publication bias with funnel plots. Results We identified 15 further studies to add to 18 studies from the original review. Overall delirium occurrence was 23% (95% CI 19-26%) (33 studies) though this varied according to diagnostic criteria used (highest in DSM-IV, lowest in DSM-5). There was no change from 1980 to 2019, nor was case-mix (average age of sample, proportion with dementia) different. Overall, risk of bias was moderate or low, though there was evidence of increasing publication bias over time. Discussion The incidence and prevalence of delirium in hospitals appears to be stable, though publication bias may have masked true changes. Nonetheless, delirium remains a challenging and urgent priority for clinical diagnosis and care pathways.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Gibb, K., Seeley, A., Quinn, T., Siddiqi, N., Shenkin, S., Rockwood, K., et al. (2020). The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study. Age and ageing. https://doi.org/10.1093/ageing/afaa040
Vancouver
Gibb K, Seeley A, Quinn T, Siddiqi N, Shenkin S, Rockwood K, 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 and ageing. 2020. doi:10.1093/ageing/afaa040. PMID: 32239173.
BibTeX
@article{gibb2020-32239173,
author = {Gibb, K. and Seeley, A. and Quinn, T. and Siddiqi, N. and Shenkin, S. and Rockwood, K. and Davis, D.},
title = {{The consistent burden in published estimates of delirium occurrence in medical inpatients over four decades: a systematic review and meta-analysis study}},
journal = {Age and ageing},
year = {2020},
doi = {10.1093/ageing/afaa040},
pmid = {32239173},
url = {https://doi.org/10.1093/ageing/afaa040}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Introduction Delirium is associated with a wide range of adverse patient safety outcomes, yet it remains consistently under-diagnosed.
- We investigated if changes in healthcare complexity were associated with trends in reported delirium over the last four decades.
- Results We identified 15 further studies to add to 18 studies from the original review.
- Overall delirium occurrence was 23% (95% CI 19-26%) (33 studies) though this varied according to diagnostic criteria used (highest in DSM-IV, lowest in DSM-5).
- Overall, risk of bias was moderate or low, though there was evidence of increasing publication bias over time.
Why it matters
This systematic review found that delirium occurred in 23% of adult medical inpatients overall, with no change in occurrence from 1980 to 2019. Delirium remains consistently under-diagnosed despite being associated with a wide range of adverse patient safety outcomes.
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Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 67/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people 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 | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| 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 | A review of other studies — randomisation is not credited here |
| Times cited | 5 / 7 | Cited 285 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 35.6 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 3 / 6 | Cited 6.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 12 other studies in this library |
| Still being cited | 3 / 4 | Cited 161 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Daniel H J Davis: h-index 53 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 32239173) |
| Free to read | 2 / 2 | Free to read |
| Total | 67 / 100 | — |
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