Impact of income levels on the prevalence of delirium: A secondary analysis of the World Delirium Awareness and Quality Survey in 2023
Abstract
Background Delirium is associated with functional decline and reduced quality of life. While multiple risk factors have been identified, the relationship between national income level and delirium prevalence remains unclear. Aim To examine the association between country income level and delirium prevalence. Methods We performed a secondary analysis of the World Delirium Awareness and Quality Survey (WDAD2023), a one-day international cross-sectional epidemiological study. Delirium prevalence was assessed twice daily in wards or ICUs and compared between high-income and non-high-income countries. The primary outcome was median ward/unit delirium prevalence. Secondary outcomes included differences in delirium management practices. Multivariable analyses were conducted to adjust for these factors. Results Of 1,664 responses, 1,344 were analysed. Non-high-income countries included 159 facilities in 17 countries, and high-income countries included 1,185 facilities in 24 countries. Median ward/unit delirium prevalence was higher in non-high-income countries both in the morning (16.7% vs 11.1%, p < 0.01) and evening (20.0% vs 11.1%, p < 0.01). Management practices differed significantly between groups. In exploratory multivariable analyses, non-high-income status was associated with higher delirium prevalence after adjustment for potential confounding factors (p < 0.01). Conclusions and Relevance: Country income level might be associated with delirium prevalence. The development of specific delirium protocols for countries with low resources should be considered and evaluated.
// Source
Authors: Nobuto Nakanishi, Kensuke Nakamura, Kyohei Miyamaoto, Shigeaki Inoue, Giuseppe Bellelli, Julie Sarah Benbenishty, Mark van den Boogaard, Gideon A. Caplan, Chi Ryang Chung, Muhammed Elhadi, Mohan Gurjar, Gabriel Heras La Calle, Magdalena M. Hoffmann, Marie‐Madlen Jeitziner, Karla D. Krewulak, Tanya Mailhot, Alessandro Morandi, Ricardo Kenji Nawa, Esther S. Oh, Marie Oxenbøll Collet, Maria Carolina Paulino, Peter Nydahl, Heidi L. Lindroth, Rebecca von Haken, Keibun Liu
Institutions: Hospital Israelita Albert Einstein, Johns Hopkins University, Université de Montréal, University of Basel, University of Calgary, UNSW Sydney, University of Copenhagen, Samsung Medical Center, Indiana University School of Medicine, Yokohama City University, Radboud University Nijmegen, Hiroshima University Hospital, Copenhagen University Hospital, University of Bern, Johns Hopkins Medicine, University of Lisbon, Prince Charles Hospital, Sungkyunkwan University, Hebrew University of Jerusalem, University Hospital of Bern, University Hospital Schleswig-Holstein, Alberta Health Services, Prince of Wales Hospital, University of Milano-Bicocca, Mayo Clinic, Medical University of Graz, University Medical Centre Mannheim, Radboud University Medical Center, Hiroshima University, Paracelsus Medical University, Sanjay Gandhi Post Graduate Institute of Medical Sciences, University of Tripoli, Kobe University, Yokohama City University Hospital, Prince of Wales Hospital, Prince Charles Hospital, Indiana University Indianapolis, Azienda Ospedaliera San Gerardo, Complejo Hospitalario de Jaén, Wakayama Medical University, Kobe University Hospital, Hospital da Luz, Wakayama Medical University Hospital