ArticlePharmacoepidemiology and drug safety2017
Evaluation of algorithms to identify delirium in administrative claims and drug utilization database.
Article in Pharmacoepidemiology and drug safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
75 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Can we improve delirium prevention and treatment in the emergency department? A systematic review.Journal of the American Geriatrics Society · 2022Pooled it
- Intraoperative low tidal volume ventilation and the risk of ICD-10 coded delirium and the use for antipsychotic medications.BMC anesthesiology · 2022Trial
- Delirium in diabetic ketoacidosis: a multicenter observational study of occurrence, associated factors and outcomes from 578,204 hospitalizations.Journal of endocrinological investigation · 2026Observational
- Development of phenotype algorithms for the detection of adverse events in electronic health record data: a multicentre study.BMJ open · 2026Article
- Disparities in Physical Restraints and Antipsychotic use in Hospitalized Patients with Limited English Proficiency.Journal of general internal medicine · 2026Article
- Days at Home After Hip Fracture Among Older Adults With and Without Dementia.JAMA network open · 2026Article
- Association Between ICD-Coded Delirium and Health Determinants in The Atherosclerosis Risk in Communities Study.Journal of the American Geriatrics Society · 2026Article
- Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Is Associated With Lower Opioid Consumption and a Reduced Incidence of Delirium in Cancer Patients Receiving Chemotherapy: A Nationwide Retrospective Cohort Study in Japan.Neuropsychopharmacology reports · 2026Article
- Substance Use and Delirium Trends in the Critically Ill During the Peri-COVID Period.Critical care explorations · 2026Article
- The genetic architecture of postoperative delirium after major surgery and its relationship with nonpostoperative neurocognitive conditions: A genome-wide association study.PLoS medicine · 2026Article
- Early prediction of postoperative delirium in major surgery patients using multimodal preoperative EHR and medical notes: a retrospective cohort study in the Indiana network for patient care.BMJ public health · 2026Article
- Additional hospitalization costs associated with delirium among older adults: evidence from the Medicare Current Beneficiary Survey.Frontiers in public health · 2026Article
- Incidence and risk factors of postoperative delirium in children with congenital heart disease.PloS one · 2026Article
- Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022.The western journal of emergency medicine · 2025Article
- Cholecystitis Treatment and Outcomes Among People Living With Dementia.Journal of the American Geriatrics Society · 2025Article
- Drug-Event Pairs as Indicators for the Detection of Adverse Drug Reactions during Hospitalization in Routinely Collected Electronic Data Sources.Clinical pharmacology and therapeutics · 2025Article
- Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- Development and Validation of a Routine Electronic Health Record-Based Delirium Prediction Model for Surgical Patients Without Dementia: Retrospective Case-Control Study.JMIR perioperative medicine · 2025Article
- Postoperative use of sleep aids and delirium in older adults after major surgery: A retrospective cohort study.Journal of the American Geriatrics Society · 2024Article
- Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia.Journal of the American Medical Directors Association · 2024Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
purposeTo evaluate the performance of delirium-identification algorithms in administrative claims and drug utilization data.
methodsWe used data from a prospective study of 184 older adults who underwent aortic valve replacement at a single academic medical center to evaluate the following delirium-identification algorithms: (1) International Classification of Diseases (ICD) diagnosis codes for delirium; (2) antipsychotics use; (3) either ICD diagnosis codes or antipsychotics use; and (4) both ICD diagnosis codes and antipsychotics use. These algorithms were evaluated against a validated bedside assessment, the Confusion Assessment Method, and a validated delirium severity scale, the CAM-S.
resultsDelirium occurred in 66 patients (36%), of which 14 (21%) had hyperactive or mixed features and 15 (23%) had severe delirium. ICD diagnosis codes for delirium were present in 15 patients (8%). Antipsychotics were used in 13 patients (7%). ICD diagnosis codes alone and antipsychotics use alone had comparable sensitivity (18% vs. 18%) and specificity (98% vs. 99%). Defining delirium using either ICD diagnosis codes or antipsychotics use, sensitivity improved to 30% with little change in specificity (97%). This algorithm showed higher sensitivity for hyperactive or mixed delirium (64%) and severe delirium (73%). Requiring both ICD diagnosis codes and antipsychotics use resulted in perfect specificity but low sensitivity (6%).
conclusionDelirium-identification algorithms in claims data have low sensitivity and high specificity. Defining delirium using ICD diagnosis codes or antipsychotics use performs better than considering either type of information alone. This information should inform the design and interpretation of claims-based comparative effectiveness and safety research. Copyright © 2017 John Wiley & Sons, Ltd.
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