What is the Delirium Bibliography? The searchable Delirium Bibliography page is one of our most popular features, allowing you to quickly gain access to the literature on delirium and acute care of older persons. It is primarily intended for clinicians and researchers interested in exploring these topics. The NIDUS team keeps it updated for you on a monthly basis!
How to Search for Articles: Search by author, title, year, and/or keywords. Each article is indexed by keywords taken from MEDLINE and other relevant databases. Click on the title of the article to read the abstract, journal, etc.
Reference Information
- Title
- Persistence of Delirium in Postacute Care at Skilled Nursing Facilities
- Authors
- Park, C. M. Shi, S. Jones, R. N. Metzger, E. D. Vasunilashorn, S. M. Fong, T. Kim, D. H. Inouye, S. K.
- Year
- 2025
- Journal
- JAMA Netw Open
- Abstract
IMPORTANCE: The 2014 Improving Medicare Post-Acute Care Transformation (IMPACT) Act aimed to improve postacute care quality and outcomes. This study examines changes in delirium, a key quality indicator, over 5 years following its implementation. OBJECTIVE: To compare the persistence and resolution of delirium within skilled nursing facilities (SNFs) between 2014 and 2019. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included SNF admissions from a 5% Medicare random sample, with delirium assessments conducted between January 1 and December 31 in 2014 and 2019. The analysis of persistent delirium consisted of patients with delirium at SNF admission and a subsequent delirium assessment during their SNF stay. Analyses were conducted from December 2023 to October 2024. EXPOSURES: Year 2019 compared with year 2014. MAIN OUTCOMES AND MEASURES: Delirium was measured using the Minimum Data Set (MDS) Confusion Assessment Method at SNF admission and at a subsequent assessment within 30 days of admission. Multinomial logistic regression was used to compare the rates of resolved delirium, persistent delirium, and death between 2014 and 2019 after adjusting for patient characteristics and SNF care factors. RESULTS: The sample included a total of 432 037 SNF admissions before exclusions and 306 998 after exclusions. For SNF admissions in 2014, 6933 of 162 161 patients (4.3%) had delirium at admission, compared with 3595 of 144 837 patients (2.5%) in 2019. In 2014, there were 6096 patients (mean [SD] age, 80.6 [11.0] years; 3565 women [58.5%]), and in 2019, there were 2778 patients (mean [SD] age, 80.2 [10.7] years; 1546 women [55.7%]) with delirium and follow-up assessments. The adjusted prevalence of persistent delirium decreased from 3347 of 6096 patients (62.3%; 95% CI, 60.2%-64.4%) in 2014 to 1316 of 2778 patients (54.7%; 95% CI, 52.0%-57.4%) in 2019, whereas delirium resolution increased from 1734 of 6096 patients (29.1%; 95% CI, 27.1%-31.1%) in 2014 to 1010 of 2778 patients (37.4%; 95% CI, 34.7%-40.0%) in 2019. CONCLUSIONS AND RELEVANCE: This cross-sectional study found a reduction in the prevalence of delirium at SNF admission and an improvement in delirium resolution during the stay in the 5 years following the IMPACT Act. However, the high prevalence of persistent delirium warrants further efforts to improve delirium management in SNF.
- PMID
PMID: 40094664
PMCID: PMC11915067
- Keywords
Humans *Skilled Nursing Facilities/statistics & numerical data *Delirium/epidemiology/diagnosis Female Male Cross-Sectional Studies *Subacute Care/statistics & numerical data Aged United States/epidemiology Aged, 80 and over *Medicare/statistics & numerical data
- Page(s)
- Volume
- Issue
| Title | Authors | Journal | Year | Keywords |
|---|---|---|---|---|
| Factors Associated with Length of Stay in Hospital Patients with and Without Dementia. | Möllers, T. Perna, L. Ihle, P. Schubert, I. Bauer, J. Brenner, H. | Journal of Alzheimer's Disease | 2019 |
adult |
| Does a Year Have 6 Months or 12? Implications for Delirium Detection Among Hospitalized Older General Medicine Patients. | Zhou, W. Ngo, L. H. Inouye, S. K. Gallagher, J. Husser, E. K. Fick, D. M. Marcantonio, E. R. | Journal of General Internal Medicine | 2018 |
adult |
| Serum soluble fibrinogen-like protein 2 concentration predicts delirium after acute pancreatitis. | Xu, W. B. Hu, Q. H. Wu, C. N. Fan, Z. K. Song, Z. F. | Brain Behav | 2019 |
acute pancreatitis |
| Use of the brief Confusion Assessment Method in a veteran palliative care population: A pilot validation study. | Wilson, J. E. Boehm, L. Samuels, L. R. Unger, D. Leonard, M. Roumie, C. Ely, E. W. Dittus, R. S. Misra, S. Han, J. H. | Palliat Support Care | 2019 |
cognition |
| Relative cerebral hyperperfusion during cardiopulmonary bypass is associated with risk for postoperative delirium: a cross-sectional cohort study. | Thudium, M. Ellerkmann, R. K. Heinze, I. Hilbert, T. | BMC Anesthesiology | 2019 |
Cardiac surgery |
| Prediction of postoperative delirium by comprehensive geriatric assessment among elderly patients with hip fracture. | Tao, L. Xiaodong, X. Qiang, M. Jiao, L. Xu, Z. | Ir J Med Sci | 2019 |
Comprehensive geriatric assessment |
| The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. | Sillner, A. Y. Holle, C. L. Rudolph, J. L. | Clin Geriatr Med | 2019 |
Delirium |
| Depth of sedation as an interventional target to reduce postoperative delirium: mortality and functional outcomes of the Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients randomised clinical trial. | Sieber, F. Neufeld, K. J. Gottschalk, A. Bigelow, G. E. Oh, E. S. Rosenberg, P. B. Mears, S. C. Stewart, K. J. Ouanes, J. P. P. Jaberi, M. Hasenboehler, E. A. Wang, N. Y. | British Journal of Anaesthesia | 2019 |
NCT00590707 |
| Delirium Incidence and Functional Outcomes After Transcatheter and Surgical Aortic Valve Replacement. | Shi, S. M. Sung, M. Afilalo, J. Lipsitz, L. A. Kim, C. A. Popma, J. J. Khabbaz, K. R. Laham, R. J. Guibone, K. Lee, J. Marcantonio, E. R. Kim, D. H. | J Am Geriatr Soc | 2019 |
aortic valve replacement |
| Effect of perioperative administration of dexmedetomidine on delirium after cardiac surgery in elderly patients: a double-blinded, multi-center, randomized study. | Shi, C. Jin, J. Qiao, L. Li, T. Ma, J. Ma, Z. | Clin Interv Aging | 2019 |
anesthesia |
| Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses. | Schmitt, E. M. Gallagher, J. Albuquerque, A. Tabloski, P. Lee, H. J. Gleason, L. Weiner, L. S. Marcantonio, E. R. Jones, R. N. Inouye, S. K. Schulman-Green, D. | Gerontologist | 2019 |
*Burden |
| Association of Persistent Intense Thirst With Delirium Among Critically Ill Patients: A Cross-sectional Study. | Sato, K. Okajima, M. Taniguchi, T. | J Pain Symptom Manage | 2019 |
Thirst |
| Role of Epileptic Activity in Older Adults With Delirium, a Prospective Continuous EEG Study. | Sambin, S. Gaspard, N. Legros, B. Depondt, C. De Breucker, S. Naeije, G. | Front Neurol | 2019 |
Ncse |
| Surgical delay is a risk factor of delirium in hip fracture patients with mild–moderate cognitive impairment. | Pioli, G. Bendini, C. Giusti, A. Pignedoli, P. Cappa, M. Iotti, E. Ferri, M. A. Bergonzini, E. Sabetta, E. | Aging Clinical and Experimental Research | 2019 |
age |
| Cerebrospinal Fluid Spermidine, Glutamine and Putrescine Predict Postoperative Delirium Following Elective Orthopaedic Surgery. | Pan, X. Cunningham, E. L. Passmore, A. P. McGuinness, B. McAuley, D. F. Beverland, D. O'Brien, S. Mawhinney, T. Schott, J. M. Zetterberg, H. Green, B. D. | Sci Rep | 2019 | |
| The impact of the Hospital Elder Life Program on the treatment of asymptomatic bacteriuria: An unexpected benefit. | O'Donnell, A. J. Walsh, T. L. Tang, A. Weinberg, L. | Geriatr Nurs | 2019 |
Asymptomatic bacteriuria |
| Continuous EEG Monitoring in a Consecutive Patient Cohort with Sepsis and Delirium. | Nielsen, R. M. Urdanibia-Centelles, O. Vedel-Larsen, E. Thomsen, K. J. Moller, K. Olsen, K. S. Lauritsen, A. O. Eddelien, H. S. Lauritzen, M. Benedek, K. | Neurocrit Care | 2019 |
Brain diseases |
| Delirium risk factors and associated outcomes in a neurosurgical cohort: a case-control study. | Morshed, R. A. Young, J. S. Safaee, M. Sankaran, S. Berger, M. S. McDermott, M. W. Hervey-Jumper, S. L. | World Neurosurg | 2019 |
Delirium |
| Biomarker Predictors of Delirium in Acutely Ill Patients: A Systematic Review. | Michels, M. Michelon, C. Damasio, D. Vitali, A. M. Ritter, C. Dal-Pizzol, F. | J Geriatr Psychiatry Neurol | 2019 |
Cam |
| Predicting postoperative delirium severity in older adults: The role of surgical risk and executive function. | Lindroth, H. Bratzke, L. Twadell, S. Rowley, P. Kildow, J. Danner, M. Turner, L. Hernandez, B. Brown, R. Sanders, R. D. | Int J Geriatr Psychiatry | 2019 |
aging |
| Subsyndromal delirium is associated with poor functional outcome after ischaemic stroke. | Klimiec-Moskal, E. Lis, A. Pera, J. Slowik, A. Dziedzic, T. | European Journal of Neurology | 2019 |
aged |
| SF-36 scores predict postoperative delirium after surgery for cervical spondylotic myelopathy. | Kin, K. Yasuhara, T. Tomita, Y. Umakoshi, M. Morimoto, J. Date, I. | J Neurosurg Spine | 2019 |
CCI = Charlson Comorbidity Index |
| Effects of massage on outcomes of adult intensive care unit patients: a systematic review. | Jagan, S. Park, T. Papathanassoglou, E. | Nurs Crit Care | 2019 |
Complementary and alternative therapies |
| Perioperative Dexmedetomidine Reduces Delirium in Elderly Patients after Lung Cancer Surgery. | Huyan, T. Hu, X. Peng, H. Zhu, Z. Li, Q. Zhang, W. | Psychiatr Danub | 2019 | |
| The Oslo Study of Clonidine in Elderly Patients with Delirium; LUCID: a randomised placebo-controlled trial. | Hov, K. R. Neerland, B. E. Undseth, O. Bruun Bratholm Wyller, V. MacLullich, A. M. J. Qvigstad, E. Skovlund, E. Wyller, T. B. | Int J Geriatr Psychiatry | 2019 |
Delirium treatment |
| Delirium and Alzheimer disease: A proposed model for shared pathophysiology. | Fong, T. G. Vasunilashorn, S. M. Libermann, T. Marcantonio, E. R. Inouye, S. K. | Int J Geriatr Psychiatry | 2019 |
Alzheimer disease |
| Development and validation of a dynamic delirium prediction rule in patients admitted to the Intensive Care Units (DYNAMIC-ICU): A prospective cohort study. | Fan, H. Ji, M. Huang, J. Yue, P. Yang, X. Wang, C. Ying, W. | International journal of nursing studies | 2019 |
aged |
| Delirium and cognitive impairment among older patients in Norwegian emergency departments. | Evensen, S. Saltvedt, I. Ranhoff, A. H. Myrstad, M. Myrstad, C. Mellingsaeter, M. Wang-Hansen, M. S. Neerland, B. E. | Tidsskr Nor Laegeforen | 2019 | |
| Motor activity across delirium motor subtypes in geriatric patients assessed using body-worn sensors: a Norwegian cross-sectional study. | Evensen, S. Bourke, A. K. Lydersen, S. Sletvold, O. Saltvedt, I. Wyller, T. B. Taraldsen, K. | BMJ Open | 2019 |
accelerometer |
| Factors Associated With Delirium in Surgical Intensive Care Unit Patients Treated With Supplemental Melatonin: A Case-Cohort Study. | Cusimano, J. M. Welch, S. Perez-Protto, S. Lam, S. | Clin Neuropharmacol | 2019 | |
| Intraoperative blood transfusion predicts postoperative delirium among older patients undergoing elective orthopedic surgery: A prospective cohort study. | Chou, M. Y. Wang, Y. C. Peng, L. N. Liang, C. K. Chu, C. S. Liao, M. C. Lin, Y. T. Hsu, C. J. Chen, L. K. | Int J Geriatr Psychiatry | 2019 |
aged |
| Postoperative delirium in critically ill surgical patients: incidence, risk factors, and predictive scores. | Chaiwat, O. Chanidnuan, M. Pancharoen, W. Vijitmala, K. Danpornprasert, P. Toadithep, P. Thanakiattiwibun, C. | BMC Anesthesiology | 2019 |
Intensive care unit (ICU) |
| Differential Clinical Characteristics, Management, and Outcome of Delirium among Ward Compared with ICU Patients. | Canet, E. Amjad, S. Robbins, R. Lewis, J. Matalanis, M. Jones, D. Bellomo, R. | Intern Med J | 2019 |
Agitation |
| Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank. | Bowman, K. Jones, L. Pilling, L. C. Delgado, J. Kuchel, G. A. Ferrucci, L. Fortinsky, R. H. Melzer, D. | Neurology | 2019 | |
| Single-bed rooms in a geriatric ward prevent delirium in older patients. | Blandfort, S. Gregersen, M. Rahbek, K. Juul, S. Damsgaard, E. M. | Aging Clin Exp Res | 2019 |
Delirium |
| Drug Prescription and Delirium in Older Inpatients: Results From the Nationwide Multicenter Italian Delirium Day 2015-2016. | Aloisi, G. Marengoni, A. Morandi, A. Zucchelli, A. Cherubini, A. Mossello, E. Bo, M. Di Santo, S. G. Mazzone, A. Trabucchi, M. Cappa, S. Fimognari, F. L. Incalzi, R. A. Gareri, P. Perticone, F. Campanini, M. Montorsi, M. Latronico, N. Zambon, A. Bellelli, | J Clin Psychiatry | 2019 | |
| Patient Safety Incidents Describing Patient Falls in Critical Care in North West England Between 2009 and 2017. | Thomas, A. N. Balmforth, J. E. | J Patient Saf | 2019 | |
| Have you SCAND MMe Please? A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit. | Redley, B. Baker, T. | Journal of Clinical Nursing | 2019 |
acute disease |
| Low-Dose Ketamine Infusion to Decrease Postoperative Delirium for Spinal Fusion Patients. | Plyler, S. S. Muckler, V. C. Titch, J. F. Gupta, D. K. Rice, A. N. | J Perianesth Nurs | 2019 |
3d-cam |
| Nurses' experiences of caring for older patients afflicted by delirium in a neurological department. | Kristiansen, S. Konradsen, H. Beck, M. | Journal of Clinical Nursing | 2019 |
adult |
| Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-analysis. | Wu, Y. C. Tseng, P. T. Tu, Y. K. Hsu, C. Y. Liang, C. S. Yeh, T. C. Chen, T. Y. Chu, C. S. Matsuoka, Y. J. Stubbs, B. Carvalho, A. F. Wada, S. Lin, P. Y. Chen, Y. W. Su, K. P. | JAMA Psychiatry | 2019 | |
| Effect of electroencephalography-guided anesthetic administration on postoperative delirium among older adults undergoing major surgery the engages randomized clinical trial. | Wildes, T. S. Mickle, A. M. Abdallah, A. B. Maybrier, H. R. Oberhaus, J. Budelier, T. P. Kronzer, A. McKinnon, S. L. Park, D. Torres, B. A. Graetz, T. J. Emmert, D. A. Palanca, B. J. Goswami, S. Jordan, K. Lin, N. Fritz, B. A. Stevens, T. W. Jacobsohn, E. | JAMA | 2019 |
NCT02241655 |
| Perioperative Epidural Use and Risk of Delirium in Surgical Patients: A Secondary Analysis of the PODCAST Trial. | Vlisides, P. E. Thompson, A. Kunkler, B. S. Maybrier, H. R. Avidan, M. S. Mashour, G. A. | Anesth Analg | 2019 | |
| Effect of Intravenous Acetaminophen vs Placebo Combined with Propofol or Dexmedetomidine on Postoperative Delirium among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial. | Subramaniam, B. Shankar, P. Shaefi, S. Mueller, A. O'Gara, B. Banner-Goodspeed, V. Gallagher, J. Gasangwa, D. Patxot, M. Packiasabapathy, S. Mathur, P. Eikermann, M. Talmor, D. Marcantonio, E. R. | JAMA | 2019 |
NCT02546765 |
| The use of a screening scale improves the recognition of delirium in older patients after cardiac surgery - a retrospective observational study. | Smulter, N. Claesson Lingehall, H. Gustafson, Y. Olofsson, B. Engstrom, K. G. | J Clin Nurs | 2019 |
Assessments scales |
| Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. | Saravana-Bawan, B. Warkentin, L. M. Rucker, D. Carr, F. Churchill, T. A. Khadaroo, R. G. | Canadian Journal of Surgery | 2019 |
aged |
| Association of Duration of Surgery With Postoperative Delirium Among Patients Receiving Hip Fracture Repair. | Ravi, B. Pincus, D. Choi, S. Jenkinson, R. Wasserstein, D. N. Redelmeier, D. A. | JAMA Netw Open | 2019 | |
| Depression Predicts Delirium After Coronary Artery Bypass Graft Surgery Independent of Cognitive Impairment and Cerebrovascular Disease: An Analysis of the Neuropsychiatric Outcomes After Heart Surgery Study. | Oldham, M. A. Hawkins, K. A. Lin, I. H. Deng, Y. Hao, Q. Scoutt, L. M. Yuh, D. D. Lee, H. B. | American Journal of Geriatric Psychiatry | 2019 |
aged |
| Accuracy of the Delirium Observational Screening Scale (DOS) as a screening tool for delirium in patients with advanced cancer. | Neefjes, E. C. W. van der Vorst, Mjdl Boddaert, M. S. A. Verdegaal, Batt Beeker, A. Teunissen, S. C. C. Beekman, A. T. F. Zuurmond, W. W. A. Berkhof, J. Verheul, H. M. W. | BMC Cancer | 2019 |
Delirium |
| The impact of intravenous isotonic and hypotonic maintenance fluid on the risk of delirium in adult postoperative patients: retrospective before-after observational study. | Nagae, M. Egi, M. Furushima, N. Okada, M. Makino, S. Mizobuchi, S. | J Anesth | 2019 |
Delirium |
| Association between delirium, adverse clinical events and functional outcomes in older patients admitted to rehabilitation settings after a hip fracture: A multicenter retrospective cohort study. | Morandi, A. Mazzone, A. Bernardini, B. Suardi, T. Prina, R. Pozzi, C. Gentile, S. Trabucchi, M. Bellelli, G. | Geriatrics & Gerontology International | 2019 |
aged |
| Handover of anesthesia care is associated with an increased risk of delirium in elderly after major noncardiac surgery: results of a secondary analysis. | Liu, G. Y. Su, X. Meng, Z. T. Cui, F. Li, H. L. Zhu, S. N. Wang, D. X. | J Anesth | 2019 |
Delirium |
| Undiagnosed delirium is frequent and difficult to predict: Results from a prevalence survey of a tertiary hospital. | Lange, P. W. Lamanna, M. Watson, R. Maier, A. B. | J Clin Nurs | 2019 |
Undiagnosed delirium |