Occurrence and outcome of delirium in medical in-patients: a systematic literature review

Age Ageing. 2006 Jul;35(4):350-64. doi: 10.1093/ageing/afl005. Epub 2006 Apr 28.


Background: Despite the acknowledged clinical importance of delirium, research evidence for measures to improve its management is sparse. A necessary first step to devising appropriate strategies is to understand how common it is and what its outcomes are in any particular setting.

Objective: To determine the occurrence of delirium and its outcomes in medical in-patients, through a systematic review of the literature.

Method: We searched electronic medical databases, the Consultation-Liaison Literature Database and reference lists and bibliographies for potentially relevant studies. Studies were selected, quality assessed and data extracted according to preset protocols.

Results: Results for the occurrence of delirium in medical in-patients were available for 42 cohorts. Prevalence of delirium at admission ranged from 10 to 31%, incidence of new delirium per admission ranged from 3 to 29% and occurrence rate per admission varied between 11 and 42%. Results for outcomes were available for 19 study cohorts. Delirium was associated with increased mortality at discharge and at 12 months, increased length of hospital stay (LOS) and institutionalisation. A significant proportion of patients had persistent symptoms of delirium at discharge and at 6 and 12 months.

Conclusion: Delirium is common in medical in-patients and has serious adverse effects on mortality, functional outcomes, LOS and institutionalisation. The development of appropriate strategies to improve its management should be a clinical and research priority. As delirium prevalent at hospital admission is a significant problem, research is also needed into preventative measures that could be applied in community settings.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Delirium / epidemiology*
  • Humans
  • Incidence
  • Inpatients*
  • Length of Stay
  • Morbidity
  • Outcome Assessment, Health Care*
  • Patient Discharge
  • Prevalence
  • Prognosis