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Journal article

Assessment and report of individual symptoms in studies of delirium in postoperative populations: a systematic review

Abstract:

Objectives

Delirium is most often reported as present or absent. Patients with symptoms falling short of the diagnostic criteria for delirium fall into ‘no delirium’ or ‘control’ groups. This binary classification neglects individual symptoms and may be hindering identification of the pathophysiology underlying delirium. This systematic review investigates which individual symptoms of delirium are reported by studies of postoperative delirium in adults.

Methods

Medline, EMBASE and Web of Science databases were searched on 03 June 2021 and 06 April 2023. Two reviewers independently examined titles and abstracts. Each paper was screened in duplicate and conflicting decisions settled by consensus discussion. Data were extracted, qualitatively synthesised and narratively reported. All included studies were quality assessed.

Results

These searches yielded 4,367 results. After title and abstract screening, 694 full-text studies were reviewed, and 62 deemed eligible for inclusion. This review details 11,377 patients including 2,049 patients with delirium. In total, 78 differently described delirium symptoms were reported. The most reported symptoms were inattention (N = 29), disorientation (N = 27), psychomotor agitation/retardation (N = 22), hallucination (N = 22) and memory impairment (N = 18). Notably, psychomotor agitation and hallucinations are not listed in the current Diagnostic and Statistical Manual for Mental Disorders-5-Text Revision delirium definition.

Conclusions

The 78 symptoms reported in this systematic review cover domains of attention, awareness, disorientation and other cognitive changes. There is a lack of standardisation of terms, and many recorded symptoms are synonyms of each other. This systematic review provides a library of individual delirium symptoms, which may be used to inform future reporting.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1093/ageing/afae077

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
ORCID:
0000-0003-2631-0288
More by this author
Role:
Author
ORCID:
0000-0002-2689-4335
More by this author
Role:
Author
ORCID:
0000-0002-8479-9977


More from this funder
Funder identifier:
https://ror.org/0161w0r98


Publisher:
Oxford University Press
Journal:
Age and Ageing More from this journal
Volume:
53
Issue:
4
Article number:
afae077
Place of publication:
England
Publication date:
2024-04-18
Acceptance date:
2024-03-22
DOI:
EISSN:
1468-2834
ISSN:
0002-0729
Pmid:
38640126


Language:
English
Keywords:
Pubs id:
2009353
Local pid:
pubs:2009353
Deposit date:
2024-07-19

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