Evidence map›Paper›PMID 36104137›Full record

Observational studyBMJ open2022

Demographic and clinical characteristics of patients with delirium: analysis of a nationwide Japanese medical database.

Naoya Ueda, Masakazu Igarashi, Kotoba Okuyama, Hideki Sano, Kanae Takahashi, Zaina P Qureshi, Shigeru Tokita, Asao Ogawa, Yasuyuki Okumura, Shoki Okuda

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 20% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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  5. Article
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  7. Observational
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

10 authors at 3 institutions in 2 countries.

Naoya UedaMedical Affairs, MSD KK, Tokyo, Japan.
Masakazu IgarashiMedical Affairs, MSD KK, Tokyo, Japan.
Kotoba OkuyamaMedical Affairs, MSD KK, Tokyo, Japan.
Hideki SanoMedical Affairs, MSD KK, Tokyo, Japan.
Kanae TakahashiJapan Development, MSD KK, Tokyo, Japan.
Zaina P QureshiCenter for Observational and Real-world Evidence (CORE), Merck & Co, Inc, Rahway, New Jersey, USA.
Shigeru TokitaMedical Affairs, MSD KK, Tokyo, Japan.
Asao OgawaDivision of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan.
Yasuyuki OkumuraInitiative for Clinical Epidemiological Research, Tokyo, Japan.
Shoki OkudaMedical Affairs, MSD KK, Tokyo, Japan shoki.okuda@merck.com.ORCID 0000-0002-6336-2602
MSD K.K. (Japan) · JPChiba Cancer Center · JPMerck & Co., Inc., Rahway, NJ, USA (United States) · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDelirium commonly occurs during hospitalisation and is associated with increased mortality, especially in elderly patients. This study aimed to determine the demographic and clinical characteristics of patients with delirium in the Japanese real-world clinical setting using a nationwide database comprising claims and discharge abstract data.

designThis was an observational, cross-sectional, retrospective study in hospitalised patients with an incident delirium identified by a diagnosis based on International Classification of Diseases, 10th Revision codes or initiating antipsychotics recommended for delirium treatment in Japan during their hospitalisation.

settingPatients from the Medical Data Vision database including more than 400 acute care hospitals in Japan were evaluated from admission to discharge.

participantsOf the 32 910 227 patients who were included in the database between April 2012 and September 2020, a total of 145 219 patients met the criteria for delirium. PRIMARY AND SECONDARY OUTCOME MEASURES: Demographic and baseline characteristics, comorbidities, clinical profiles and pharmacological treatments were evaluated in patients with delirium.

resultsThe mean (SD) patient age was 76.5 (13.8) years. More than half of the patients (n=82 159; 56.6%) were male. The most frequent comorbidities were circulatory system diseases, observed in 81 954 (56.4%) patients. Potentially inappropriate medications (PIMs) with risk of delirium including benzodiazepines and opioids were prescribed to 76 798 (52.9%) patients. Approximately three-fourths of these patients (56 949; 74.2%) were prescribed ≥4 PIMs. The most prescribed treatment for delirium was injectable haloperidol (n=82 490; 56.8%). Mean (SD) length of hospitalisation was 16.0 (12.1) days.

conclusionsThe study results provide comprehensive details of the clinical characteristics of patients with delirium and treatment patterns with antipsychotics in the Japanese acute care setting. In this patient population, the prescription rate of injectable haloperidol and PIMs was high, suggesting the need for improved understanding among healthcare providers about the appropriate management of delirium, which may benefit patients.

Indexed as

Antipsychotic AgentsDeliriumAgedCross-Sectional StudiesDemographyFemaleHaloperidolHumansJapanMaleRetrospective StudiesAntipsychotic AgentsHaloperidoldelirium & cognitive disordersepidemiologypsychiatry

Identifiers

PMID36104137
PMCPMC9476131
OpenAlexW4295681551

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.