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lüll Occurrence and outcome of delirium in medical in-patients: a systematic literature review Siddiqi N; House AO; Holmes JDAge Ageing 2006[Jul]; 35 (4): 350-64BACKGROUND: 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.|*Inpatients[MESH]|*Outcome Assessment, Health Care[MESH]|Aged[MESH]|Delirium/*epidemiology[MESH]|Humans[MESH]|Incidence[MESH]|Length of Stay[MESH]|Morbidity[MESH]|Patient Discharge[MESH]|Prevalence[MESH]|Prognosis[MESH] |