SynthesisCritical care medicine2018
Delirium Monitoring in Neurocritically Ill Patients: A Systematic Review.
Synthesis in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The associations of post-stroke delirium with outcomes: a systematic review and meta-analysis.BMC medicine · 2024Pooled it
- Associations Between Stroke Localization and Delirium: A Systematic Review and Meta-Analysis.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022Pooled it
- Delirium in neurosurgery: a systematic review and meta-analysis.Neurosurgical review · 2022Pooled it
- Detecting delirium in patients with acute stroke: a systematic review of test accuracy.BMC neurology · 2019Pooled it
- Feasibility of low-dose dexmedetomidine for prevention of postoperative delirium after intracranial operations: a pilot randomized controlled trial.BMC neurology · 2021Trial
- Effect of Neurologic Conditions on Delirium Duration and Time to ICU Discharge.Critical care explorations · 2026Observational
- Observational
- Diagnostic Accuracy of CAM-ICU and ICDSC for Detection of Early Delirium in Acute Ischemic Stroke: A Cross-sectional Study.Annals of Indian Academy of Neurology · 2026Article
- Prevention of Unbearable Situations and Harms Protocol: A Quality Improvement Initiative in Neurological Delirium.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Brain Protective Ventilation Strategies in Severe Acute Brain Injury.Current neurology and neuroscience reports · 2025Review
- Delirium as a mediating factor in the survival benefits of dexmedetomidine in acute brain injury management.Scientific reports · 2025Article
- [Incidence and factors associated with delirium in an Emergency Department].Revista medica del Instituto Mexicano del Seguro Social · 2025Observational
- Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke.Critical care medicine · 2024Article
- Delirium and Its Associations with Critical Care Utilizations and Outcomes at the Time of Hospital Discharge in Patients with Acute Brain Injury.Medicina (Kaunas, Lithuania) · 2024Article
- Concurrence of seizures and peri-ictal delirium in the critically ill - its frequency, associated characteristics, and outcomes.Journal of neurology · 2024Observational
- Development of a machine learning-based prediction model for sepsis-associated delirium in the intensive care unit.Scientific reports · 2023Article
- Assessing Patients With Altered Level of Consciousness.Critical care nurse · 2023Article
- Prevalence and Risk Factors for Intensive Care Unit Delirium After Traumatic Brain Injury: A Retrospective Cohort Study.Neurocritical care · 2023Article
- Dynamic predictors of in-hospital and 3-year mortality after traumatic brain injury: A retrospective cohort study.American journal of surgery · 2023Article
- Bayes' Theorem in Neurocritical Care: Principles and Practice.Neurocritical care · 2023Review
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
objectivesThe Society of Critical Care Medicine recommends routine delirium monitoring, based on data in critically ill patients without primary neurologic injury. We sought to answer whether there are valid and reliable tools to monitor delirium in neurocritically ill patients and whether delirium is associated with relevant clinical outcomes (e.g., survival, length of stay, functional independence, cognition) in this population. DATA SOURCES: We systematically reviewed Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed. STUDY SELECTION AND DATA EXTRACTION: Inclusion criteria allowed any study design investigating delirium monitoring in neurocritically ill patients (e.g., neurotrauma, ischemic, and/or hemorrhagic stroke) of any age. We extracted data relevant to delirium tool sensitivity, specificity, negative predictive value, positive predictive value, interrater reliability, and associated clinical outcomes. DATA SYNTHESIS: Among seven prospective cohort studies and a total of 1,173 patients, delirium was assessed in neurocritically patients using validated delirium tools after considering primary neurologic diagnoses and associated complications, finding a pooled prevalence rate of 12-43%. When able to compare against a common reference standard, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the test characteristics showed a sensitivity of 62-76%, specificity of 74-98%, positive predictive value of 63-91%, negative predictive value of 70-94%, and reliability kappa of 0.64-0.94. Among four studies reporting multivariable analyses, delirium in neurocritically patients was associated with increased hospital length of stay (n = 3) and ICU length of stay (n = 1), as well as worse functional independence (n = 1) and cognition (n = 2), but not survival.
conclusionsThese data from studies of neurocritically ill patients demonstrate that patients with primary neurologic diagnoses can meet diagnostic criteria for delirium and that delirious features may predict relevant untoward clinical outcomes. There is a need for ongoing investigations regarding delirium in these complicated neurocritically ill patients.
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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.