Evidence map›Paper›PMID 26041151›Full record

SynthesisBMJ (Clinical research ed.)2015

Outcome of delirium in critically ill patients: systematic review and meta-analysis.

Jorge I F Salluh, Han Wang, Eric B Schneider, Neeraja Nagaraja, Gayane Yenokyan, Abdulla Damluji, Rodrigo B Serafim, Robert D Stevens

8 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 8 registered trials, which are not on this map. Cited by 414 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
414citing papers in PubMed, 22 pooled it
43.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02899156 phase4terminatednot on this mapstarted 2016, after this paper: background citation

Effect of Flumazenil on Hypoactive Delirium in the ICU: A Double-Blind, Placebo-Controlled Pilot Study

TypeinterventionalSponsorUniversity of California, DavisRan2016 to 2019Enrolled22ConditionsHypoactive DeliriumArmsFlumazenil, Placebo
NCT03199950 phase4unknown statusnot on this mapstarted 2017, after this paper: background citation

Delirium: Is Prophylactic Drug Therapy Useful in High Risk Patients as Defined by the Delirium Risk Prediction Model?

TypeinterventionalSponsorZuyderland Medisch CentrumRan2017 to 2018Enrolled1,366ConditionsDeliriumArmsHaloperidol, Placebo Oral Tablet
NCT03572517 nacompletednot on this mapstarted 2017, after this paper: background citation

Comparison of Two Different Anesthetic Techniques on Incidence of Postoperative Delirium in Cancer Patients After Laparoscopic Surgery in Trendelenburg Position: A Prospective Randomized Clinical Trial

TypeinterventionalSponsorAC Camargo Cancer CenterRan2017 to 2018Enrolled65ConditionsDelirium, AnesthesiaArmsSubarachnoid block, Spinal morphine
NCT03642249 nacompletednot on this mapstarted 2019, after this paper: background citation

Evaluating the Effects of Implementing an Scenario-based Education Initiative and OSCE for Recognition and Management of Delirium in Adult Intensive Care Unit: Randomised Controlled Trial

TypeinterventionalSponsorTaipei Medical UniversityRan2019 to 2019Enrolled72ConditionsDelirium, Intensive Care Unit Syndrome, Nurse-Patient RelationsArmsOSCEs, Lecture, E-learning
NCT04953767 naunknown statusnot on this mapstarted 2021, after this paper: background citation

The Circadian Rhythm of ICU Patients With Acute Myocardial Infraction and the Effect of Dynamic Light Therapy : A Preliminary Study

TypeinterventionalSponsorChang Gung Memorial HospitalRan2021 to 2024Enrolled70ConditionsCircadian Dysrhythmia, DeliriumArmsBlue light therapy, White light
NCT06667869 recruitingnot on this mapstarted 2025, after this paper: background citation

Sistema de monitorización multiparámetros Para sedación de Pacientes críticos en UCI (ROMANTIC: multipaRameter mOnitoring systeM for sedAtion iNThe ICu)

Typeobservational_patient_registrySponsorPontificia Universidad Catolica de ChileRan2025 to 2026Enrolled80ConditionsSedation ComplicationArmsSedative
NCT06817239 narecruitingnot on this mapstarted 2025, after this paper: background citation

Effect of Perioperative Low-dose EsketaMine on dElirium in High-risk Elderly Patients uNdergoing elecTive Major Non-cardiac Surgery: a Multi-center Randomized Trial (ELEMENT Trial)

TypeinterventionalSponsorNanfang Hospital, Southern Medical UniversityRan2025 to 2027Enrolled1,670ConditionsDelirium in Old Age, Delirium, Postoperative, Anesthesia, Cognitive DysfunctionArmsEsketamine, Normal saline
NCT07776184 naactive not recruitingnot on this mapstarted 2026, after this paper: background citation

From Reactive Management to Proactive Prevention: Implementing a Multi-Component Bundle to Reduce Delirium in the Aging CICU Population

TypeinterventionalSponsorTel Aviv Medical CenterRan2026 to 2027Enrolled200ConditionsDelirium in Old Age, Delirium in the Intensive Care Unit, Delirium Confusional State, DeliriumArmsMulticomponent Delirium Prevention Bundle, Control Group
3 · Its place in the literature

Who cites it

414 citing papers in PubMed, 22 syntheses or guidelines pooled it, 984 citations in OpenAlex.

  1. Nonpharmacological interventions for preventing delirium in adult patients with cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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  11. Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
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354 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Jorge I F SalluhD'OR Institute for Research and Education, Rio de Janeiro, Brazil.
Han WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eric B SchneiderDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neeraja NagarajaDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Gayane YenokyanDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abdulla DamlujiElaine and Sydney Sussman Cardiac Catheterization Laboratories, Cardiovascular Division, University of Miami Miller School of Medicine, Miami, FL, USA.
Rodrigo B SerafimD'OR Institute for Research and Education, Rio de Janeiro, Brazil Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Robert D StevensDepartment of Anesthesiology and Critical Care Medicine, Neurology, Neurosurgery, and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Johns Hopkins University · USD’Or Institute for Research and Education · BRJohns Hopkins Medicine · USUniversity of Miami · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo determine the relation between delirium in critically ill patients and their outcomes in the short term (in the intensive care unit and in hospital) and after discharge from hospital.

designSystematic review and meta-analysis of published studies. DATA SOURCES: PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO, with no language restrictions, up to 1 January 2015. ELIGIBILITY CRITERIA FOR SELECTION STUDIES: Reports were eligible for inclusion if they were prospective observational cohorts or clinical trials of adults in intensive care units who were assessed with a validated delirium screening or rating system, and if the association was measured between delirium and at least one of four clinical endpoints (death during admission, length of stay, duration of mechanical ventilation, and any outcome after hospital discharge). Studies were excluded if they primarily enrolled patients with a neurological disorder or patients admitted to intensive care after cardiac surgery or organ/tissue transplantation, or centered on sedation management or alcohol or substance withdrawal. Data were extracted on characteristics of studies, populations sampled, identification of delirium, and outcomes. Random effects models and meta-regression analyses were used to pool data from individual studies.

resultsDelirium was identified in 5280 of 16,595 (31.8%) critically ill patients reported in 42 studies. When compared with control patients without delirium, patients with delirium had significantly higher mortality during admission (risk ratio 2.19, 94% confidence interval 1.78 to 2.70; P<0.001) as well as longer durations of mechanical ventilation and lengths of stay in the intensive care unit and in hospital (standard mean differences 1.79 (95% confidence interval 0.31 to 3.27; P<0.001), 1.38 (0.99 to 1.77; P<0.001), and 0.97 (0.61 to 1.33; P<0.001), respectively). Available studies indicated an association between delirium and cognitive impairment after discharge.

conclusionsNearly a third of patients admitted to an intensive care unit develop delirium, and these patients are at increased risk of dying during admission, longer stays in hospital, and cognitive impairment after discharge.

Indexed as

AdultCognition DisordersCritical CareCritical IllnessDeliriumEpidemiologic MethodsFemaleHumansLength of StayMalePatient DischargeRespiration, ArtificialTreatment Outcome

Identifiers

PMID26041151
PMCPMC4454920
OpenAlexW2158946857

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 2 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.