Trial reportJournal of the American Geriatrics Society2017
Pathway from Delirium to Death: Potential In-Hospital Mediators of Excess Mortality.
Trial report in Journal of the American Geriatrics Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04997200 (Effect of Sleep Deprivation on Breathlessness and Exercise Capacity in COPD), which is not on this map. Cited by 35 papers, 8 of them syntheses that pooled 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.
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.
Effect of Sleep Deprivation on Breathlessness and Exercise Capacity in COPD: a Randomized Crossover Trial
Who cites it
35 citing papers in PubMed, 8 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- GRADE-Based Clinical Practice Guidelines for Emergency Department Delirium Risk Stratification, Screening, and Brain Imaging in Older Patients With Suspected Delirium.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Guideline
- 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 · 2025Pooled it
- Risk factors and risk stratification approaches for delirium screening: A Geriatric Emergency Department Guidelines 2.0 systematic review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2021Pooled it
- Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients.The Cochrane database of systematic reviews · 2021Pooled it
- A call to action for delirium research: Meta-analysis and regression of delirium associated mortality.BMC geriatrics · 2020Pooled it
- Physical Harm and Death in the Context of Coercive Measures in Psychiatric Patients: A Systematic Review.Frontiers in psychiatry · 2019Pooled it
- Nutrition Support in Patients With Delirium: A Retrospective Case Series.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026Article
- The Prevalence, Risk Factors, and Short-Term Health Outcomes of Delirium in Patients Admitted to a Nephrology Ward in Eastern Europe: An Observational Prospective Cohort Study.Journal of clinical medicine · 2025Article
- The cost burden of radiation cystitis presentations and investigations.The Canadian journal of urology · 2025Article
- Improving hydration among hospitalised older adults in an acute geriatric ward with a bundled multi-component intervention.BMJ open quality · 2025Article
- Impact of hospital readmissions following hospitalisation with delirium on 12-month mortality: a quaternary Australian hospital experience.European geriatric medicine · 2025Article
- Geriatric care-related outcomes in patients 75 years and older admitted to a pulmonary disease center and predictors for hospital-related complications.Aging medicine (Milton (N.S.W)) · 2023Article
- Biomarkers of delirium risk in older adults: a systematic review and meta-analysis.Frontiers in aging neuroscience · 2023Review
- Dying with behavioral and psychological symptoms of dementia in Australian nursing homes: a retrospective case-control study.Frontiers in psychiatry · 2023Article
- Delirium in a surgical context from a nursing perspective: A hybrid concept analysis.International journal of nursing studies advances · 2022Article
- The development of a web-based app employing machine learning for delirium prevention in long-term care facilities in South Korea.BMC medical informatics and decision making · 2022Review
- Hospital complications among older adults: Better processes could reduce the risk of delirium.Health services management research · 2022Article
- Positive scores on the 4AT delirium assessment tool at hospital admission are linked to mortality, length of stay and home time: two-centre study of 82,770 emergency admissions.Age and ageing · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
objectives(1) To determine the relationship of incident delirium during hospitalization with 90-day mortality; (2) to identify potential in-hospital mediators through which delirium increases 90-day mortality.
designAnalysis of data from Project Recovery, a controlled clinical trial of a delirium prevention intervention from 1995 to 1998 with follow-up through 2000.
settingLarge academic hospital.
participantsPatients ≥70 years old without delirium at hospital admission who were at intermediate-to-high risk of developing delirium and received usual care only. MEASUREMENTS: (1) Incident delirium; (2) potential mediators of delirium on death including use of restraining devices (physical restraints, urinary catheters), development of hospital acquired conditions (HACs) (falls, pressure ulcers), and exposure to other noxious insults (sleep deprivation, acute malnutrition, dehydration, aspiration pneumonia); (3) death within 90 days of admission.
resultsAmong 469 patients, 70 (15%) developed incident delirium. These patients were more likely to experience restraining devices (37% vs 16%, P < .001), HACs (37% vs 12%, P < .001), other noxious insults (63% vs 49%, P = .03), and 90-day mortality (24% vs 6%, P < .001). The inverse probability weighted hazard of death due to delirium was 4.2 (95% CI = 2.8-6.3) in bivariable analyses, increased in a graded manner with additional exposures to restraining devices, HACs, and other noxious insults, and declined by 10.9% after addition of these potential mediator categories, providing evidence of mediation.
conclusionRestraining devices, HACs, and additional noxious insults were more frequent among patients with delirium, increased mortality in a graded manner, and were responsible for a significant percentage of the association of delirium with death. Additional efforts to prevent potential downstream mediators through which delirium increases mortality may help to improve outcomes among hospitalized older adults.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.