BACKGROUND Delirium is a common severe neuropsychiatric condition secondary to physical illness, which predominantly affects older adults in hospital. Prior to this study, the UK point prevalence of delirium was unknown. We set out to ascertain the point prevalence of delirium across UK hospitals and how this relates to adverse outcomes. METHODS We conducted a prospective observational study across 45 UK acute care hospitals. Older adults aged 65 years and older were screened and assessed for evidence of delirium on World Delirium Awareness Day (14th March 2018). We included patients admitted within the previous 48 h, excluding critical care admissions. RESULTS The point prevalence of Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5) delirium diagnosis was 14.7% (222/1507). Delirium presence was associated with higher Clinical Frailty Scale (CFS): CFS 4-6 (frail) (OR 4.80, CI 2.63-8.74), 7-9 (very frail) (OR 9.33, CI 4.79-18.17), compared to 1-3 (fit). However, higher CFS was associated with reduced delirium recognition (7-9 compared to 1-3; OR 0.16, CI 0.04-0.77). In multivariable analyses, delirium was associated with increased length of stay (+ 3.45 days, CI 1.75-5.07) and increased mortality (OR 2.43, CI 1.44-4.09) at 1 month. Screening for delirium was associated with an increased chance of recognition (OR 5.47, CI 2.67-11.21). CONCLUSIONS Delirium is prevalent in older adults in UK hospitals but remains under-recognised. Frailty is strongly associated with the development of delirium, but delirium is less likely to be recognised in frail patients. The presence of delirium is associated with increased mortality and length of stay at one month. A national programme to increase screening has the potential to improve recognition.

中文翻译：

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谵妄在老年住院患者中普遍存在，并与不良后果相关：世界谵妄宣传日前瞻性多中心研究的结果。

背景技术谵妄是继发于身体疾病的常见严重神经精神疾病，主要影响住院的老年人。在这项研究之前，英国谵妄的流行率是未知的。我们着手确定英国医院谵妄的流行率以及这与不良结果的关系。方法 我们在 45 家英国急症护理医院进行了一项前瞻性观察研究。在世界谵妄宣传日（2018 年 3 月 14 日）对 65 岁及以上的老年人进行了筛查和评估谵妄的证据。我们纳入了过去 48 小时内入院的患者，不包括重症监护入院。结果精神疾病诊断和统计手册第五版（DSM-5）谵妄诊断的点患病率为14.7%（222/1507）。谵妄与较高的临床虚弱量表 (CFS) 相关：CFS 4-6（虚弱）（OR 4.80，CI 2.63-8.74），7-9（非常虚弱）（OR 9.33，CI 4.79-18.17），与 1 相比-3（适合）。然而，较高的 CFS 与谵妄识别率降低相关（7-9 与 1-3 相比；OR 0.16，CI 0.04-0.77）。在多变量分析中，谵妄与 1 个月时住院时间增加（+ 3.45 天，CI 1.75-5.07）和死亡率增加（OR 2.43，CI 1.44-4.09）相关。谵妄筛查与识别机会增加相关（OR 5.47，CI 2.67-11.21）。结论 谵妄在英国医院的老年人中普遍存在，但仍未得到充分认识。虚弱与谵妄的发展密切相关，但在虚弱的患者中不太可能发现谵妄。谵妄的存在与死亡率增加和一个月的住院时间有关。增加筛查的国家计划有可能提高识别率。