Prevalence rates of delirium range widely depending on patient population and treatment setting. Information on rates of delirium in community settings is limited, but in emergency and hospital settings, one-quarter or more of the patients will experience delirium. Rates can be even higher in older individuals, critical care patients, and patients who have had major orthopedic or cardiovascular surgeries.
Prevention, early detection, and optimal treatment are critical because delirium is often unrecognized and is associated with increased morbidity and mortality. For example, postsurgical delirium has been reported to have a 30-day mortality rate of up to 10%, versus 1% in postsurgical patients without delirium. Additionally, delirium exacts a significant economic toll on individuals, their families, and society because of longer hospital stays, ICU admissions, rehospitalizations, and lost wages. In the United States, direct health care costs of hospitalized older adults with delirium are significantly higher than hospitalized patients without delirium, even after adjusting for demographic and clinical factors.
The American Psychiatric Association Practice Guideline for the Prevention and Treatment of Delirium reviews current evidence-based nonpharmacological and pharmacological interventions to prevent or treat delirium in adults. In addition, it includes statements related to assessment and treatment planning, which are an integral part of patient-centered care. The guideline describes approaches to implementing recommendations and suggestions in clinical practice. By providing up-to-date knowledge, the guideline aims to help clinicians feel more confident in preventing, recognizing, and treating delirium, thereby improving the care and well-being of their patients. Evidence tables, literature search results, clinical questions, and more for this guideline can be found in the online appendixes.
Guideline Writing Group, Systematic Review Group, Committee on Practice
Guidelines, APA Assembly Liaisons, Table of Contents, Acronyms/Abbreviations,
Introduction, Guideline Statement Summary, Guideline Statements and
Implementation, Nonpharmacological Interventions, Pharmacological
Interventions, Areas for Further Research, Guideline Development Process,
References, Disclosures, Individuals and Organizations That Submitted
Comments, Appendices (See Supplemental Material), Appendix A. Clinical
Questions, Appendix B. Search Strategies, Study Selection, and Search
Results, Appendix C. Review of Research Evidence Supporting Guideline
Statements, Appendix D. Evidence Tables for Individual Studies Supporting
Guideline Statements, Appendix E. Risk of Bias Ratings for Individual Studies
Supporting Guideline Statements, Appendix F. Review of Benefits and Harms,
Patient Preferences, and Other Practice Guidelines, Appendix G. Description
of Additional Studies Reviewed, Appendix H. Evidence Tables for Additional
Studies Reviewed, Appendix I. Considerations in the Use of Guidelines to
Enhance the Quality of Care References
