ArticlePloS one2018
Prognostic effects of delirium motor subtypes in hospitalized older adults: A prospective cohort study.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02899156 (Effect of Flumazenil on Hypoactive Delirium in the ICU), which is not on this map. Cited by 22 papers, 3 of them syntheses that pooled it.
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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 Flumazenil on Hypoactive Delirium in the ICU: A Double-Blind, Placebo-Controlled Pilot Study
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for primary care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Guideline
- How do predisposing factors differ between delirium motor subtypes? A systematic review and meta-analysis.Age and ageing · 2022Pooled it
- Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis.BMC geriatrics · 2021Pooled it
- Article
- Frequent in dementia, deadliest without it: delirium and mortality in hospitalised older adults.Age and ageing · 2026Article
- The Single Question in Delirium as a suitable tool to improve delirium detection in hospitalized older patients.European geriatric medicine · 2025Article
- High prevalence of unrecognized postoperative delirium in elderly patients: a prospective cohort study from a resource-limited country.Patient safety in surgery · 2025Article
- External Validation of the Walter Index for Posthospitalization Mortality Prediction in Older Adults.JAMA network open · 2025Article
- Comprehensive Geriatric Assessment as a predictor model for post-operative delirium in older adults undergoing major non-cardiac elective surgery.Frontiers in medicine · 2025Article
- Delirium in nursing home residents: is there a role of antidepressants? A cross sectional study.BMC geriatrics · 2024Article
- Circadian disturbances, anxiety and motor disturbances differentiate delirium superimposed on dementia from dementia-only.Frontiers in psychiatry · 2024Article
- Long-term mortality of critically ill patients with cancer and delirium who survived to discharge: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Prevalence and risk factors of delirium in older patients admitted to a tertiary care centre in South India: A prospective, observational study.Indian journal of anaesthesia · 2023Article
- Year in Review 2021: Noteworthy Literature in Cardiothoracic Anesthesia.Seminars in cardiothoracic and vascular anesthesia · 2022Review
- Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital.Aging clinical and experimental research · 2021Article
- Post-traumatic Stress Disorder Following Acute Delirium.Journal of clinical psychology in medical settings · 2021Review
- Tools Are Needed to Promote Sedation Practices for Mechanically Ventilated Patients.Frontiers in medicine · 2021Article
- Association of Hypoactive and Hyperactive Delirium With Cognitive Function After Critical Illness.Critical care medicine · 2020Article
- Effect of Flumazenil on Hypoactive Delirium in the ICU: A Double-Blind, Placebo-Controlled Pilot Study.Critical care explorations · 2020Article
- In Reply.Deutsches Arzteblatt international · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the association between delirium motor subtypes and hospital mortality and 12-month mortality in hospitalized older adults.
designProspective cohort study conducted from 2009 to 2015.
settingGeriatric ward of a university hospital in Sao Paulo, Brazil.
participantsWe included 1,409 consecutive admissions of acutely ill patients aged 60 years and over. We excluded admissions for end-of-life care, with missing data on the main variables, length of stay shorter than 48 hours, or when consent to participate was not given. MAIN OUTCOMES AND MEASURES: Delirium was detected using the Confusion Assessment Method and categorized in hypoactive, hyperactive, or mixed delirium. Primary outcomes were time to death in the hospital, and time to death in 12 months (for the discharged sample). Comprehensive geriatric assessment was performed at admission and included socio-demographic, clinical, functional, cognitive, and laboratory variables. Further clinical data were documented upon death or discharge. Multivariate analyses used Cox proportional hazards models adjusted for possible confounders.
resultsWe included 1,409 admissions, with a mean age of 80 years. The proportion of in-hospital deaths was 19%, with a cumulative mortality of 38% in 12 months. Delirium occurred in 47% of the admissions. Hypoactive delirium was the predominant motor subtype (53%), followed by mixed delirium (30%) and hyperactive delirium (17%). Hospital mortality rates were respectively 33%, 34% and 15%. We verified that hypoactive and mixed delirium were independently associated with hospital mortality, with respective hazard ratios of 2.43 (95%CI = 1.64-3.59) and 2.31 (95%CI = 1.53-3.50). Delirium motor subtypes were not independently predictive of 12-month mortality.
conclusionsOne in three acutely ill hospitalized older adults who suffered hypoactive or mixed delirium died in the hospital. Clinicians should be aware that hypoactive symptoms of delirium, whether shown exclusively or in alternation with hyperactive symptoms, are indicative of a worse prognosis in this population.
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