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The incidence and prevalence of delirium across palliative care settings: a systematic review
Watt CL, Momoli F, Ansari MT, et al. The incidence and prevalence of delirium across palliative care settings: a systematic review. Palliat Med 2019;33(8):865–877. doi: 10.1177/0269216319854944.
This is a systematic review and meta-analysis looking at delirium in palliative care settings. There were 2596 records screened, and 42 studies were included. A total of 16 491 palliative care patients were included. The studies were conducted in 13 different countries. Studies (n=26) were in a single centre: 12 in a specialist palliative care unit based in a hospital, 7 in a cancer centre and 7 in a hospice. Three studies were conducted in the community. Of the remaining studies, seven had specialist palliative care team advice to teams caring for inpatient medical or oncology patients. The main diagnosis in the included studies was cancer (n=34), while other studies had mixed diagnoses (n=8). To diagnose delirium, 17 different delirium diagnostic tools were used. The Confusion Assessment Method was the most frequently used (n=17), followed by the Diagnostic and Statistical Manual of Mental Disorders-IV (n=10). The point prevalence estimate of delirium in the community was 4%–12%, in hospital palliative care consultative services was 9%–57% and in inpatient palliative care units was 6%–74%. Across all palliative care settings (n=8), the prevalence of delirium prior to death was 42%–88%. Only one study had an overall low risk of bias. In the …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.