Table 2. Documentation and coding rates in studies with and without additional delirium ascertainment methods.
| Author, year of publication | RoB ratinga | Sample size (female %) | No. of patients with ascertained delirium (prevalence rate %)b | No. of Patients with delirium in DS (%)c | No. of patients with delirium in HAS (%)d | Delirium ascertainment method | Hospital coding format |
|---|---|---|---|---|---|---|---|
| Alhaidari 2017 | M | 100 (46.0) | 49/100 (49.0) | 19/49 (38.8) | 19/39 (48.7)e | Documented features sufficient to fulfil short CAM | ICD-10 |
| Bui 2017 | M | 1055 (51.0) | 423/1055 (40.1) | N/A | 22/423 (5.2) | CAM-ICU | ICD-9-CM |
| Campbell 2014 | L | 424(N/A) | 163/424 (38.4) | N/A | 52/163 (31.9) | CAM | ICD-9 |
| Casey 2019 | H | 559 (54.6) | 91/559 (16.3) | N/A | Overall: 58/559 (10.3) Study-ascertained delirium: 31/91 (34.1) | 4AT 3D-CAM | ICD-10 |
| Chuen2021 | H | 110 (44.5) | 110/110 (100.0) | 70/110 (63.6) | N/A | CHART-DEL | N/A |
| Detweiler 2014 | H | 183 (3.3) | 52/183 (28.4) | 5/52 (9.6) | N/A | DSM-IV TR | N/A |
| Glick 1996 | H | Overall: 195 (N/A) Sub-study: 67 (N/A)f | 67/195 (34.4) | Overall: 12/195 (6.2) Sub-study: 8/67 (11.9)f | N/A | DSM-III | N/A |
| Heriot 2017 | M | 348 (41.9) | 104/348 (29.9) | N/A | 36/104 (34.6) | DSM-IV Chart review | ICD-10 |
| Hope 2014 | H | 25g (4.0) | 25/25g (100.0) | 11/25 (44.0) | 7/25 (28.0) | DMHC notes Chart review | ICD-9 |
| Inouye 2005 | H | 919 (60.0) | 115/919 (12.5) | N/A | 3/115 (2.6) | CAM MMSE | ICD-9CM |
| Johnson 1992 | H | 235 (N/A) | 48/235 (20.4) | N/A | 2/47h (4.3) | MMSE BPRS DSM-III Clinical/Psychiatric examination | ICD-9CM |
| Katznelson 2010 | M | 1528 (29.0) | 182/1528 (11.8) | N/A | 46/182 (25.3) | CAM-ICU | ICD-10 |
| Pendlebury 2020 | M | 1281 (52.0) | 320/1281 (25.0) | N/A | 111/320 (34.7)i | DSM-IV | ICD-10li |
| Ruangratsamee 2016 | M | 225 (59.1) | 110/225 (48.9) | 16/110 (14.5) | N/A | DSM-IV | N/A |
| Sanchez 2013 | H | 5325 (N/A) | 410/5325 (7.7) | N/A | N/A (29.5) | DSM-IV | ICD-10 |
| Smulter 2019 | M | 142 (30.8) | 78/142 (54.9) | 41/78 (52.6) | 16/78 (20.5) | OBS Scale MMSE DSM-IV-TR | ICD-10 |
| van Zyl 2003 | H | 31 (64.5) | 31/31 (100.0) | 5/31 (16.1) | N/A | DSM-IV DRS DRS-R-98 | N/A |
| Welch 2018 | M | 1327 (62.0) | 125/1327 (9.4) | 61/125 (49.0) | N/A | DSM-IV | N/A |
| Welch 2019 | H | 1507 (54.2) | 222/1507 (14.7) | 44/154 (28.6)j | N/A | 4AT DSM-V | N/A |
| Zalon 2017 | H | 34 (82.4) | 34/34 (100.0) | 1/34 (2.9) | 13/34 (38.2) | CAM | ICD-9 |
| Studies which did not use additional delirium ascertainment methods | |||||||
| Bellelli 2015 | L | 2521 (50.8) | N/A | N/A | 72/2521 (2.9) | N/A | ICD-9 |
| Kales 2003 | H | 267947 (2.0) | N/A | N/A | 3978/267947 (1.5)m | N/A | ICD-9CM |
| Kelly 2012 | H | Overall: 64046 (44.0) Sub-study: 53 (N/A)l | N/A | Overall: 89/64046 (0.1)k Sub-study: 8/53 (15.1) | N/A | N/A | ‘Delirium’ or ‘encephalopathy’ in ‘discharge problem list’ |
| McCoy 2017 | H | 809512 (54.8) | N/A | 7579/809512 (0.9)k | 27513/809512 (3.4)m | N/A | ICD-9 |
RoB = Risk of Bias. RoB was assessed using the EPHPP tool. In this table, we provide the Global RoB rating.
Number of patients with study-ascertained delirium is provided in relation to the overall sample size. We assessed study prevalence rate for delirium as the number of patients with delirium (cases), as assessed by the study delirium ascertainment method, divided by the overall sample size * 100.
Number of patients with delirium in discharge summary in relation to study-ascertained delirium N (%) and/or in relation to whole study sample if different.
Number of patients with delirium in hospital administrative databases in relation to study-ascertained delirium N (%) and/or in relation to whole study sample if different.
The authors reported ICD-9 coding rates in 39 of the 49 patients with delirium documented in clinical records.
The authors reported on a sub-group of patients who had diagnosis of delirium made by a retrospective chart review.
The authors reported documentation and coding rates in reference to the overall sample size (N=25).
The authors reported patient records for 47 of the 48 patients with delirium were available.
Though the authors reported an overall coding rate of 34.7% in HAS, there was a big increase over time in coding rates from 12.8% in 2010 to 60.2% in 2018.
The authors reported that discharge documentation were available for 154 of the 222 patients identified with study-ascertained delirium.
Number of patients with delirium in DS in relation to whole study sample N(%).
The authors also reported on a sub-group of patients who had a diagnosis of delirium previously made by the clinical team.
Number of patients with delirium in HAS in relation to whole study sample N(%).
Data not given in published study or where data is not applicable is denoted as “N/A” (not available/applicable).
All values rounded to 1 decimal place.
Table abbreviations - 3D-CAM: 3 Minute Diagnostic Assessment using Confusion Assessment Method, 4AT: The 4 ‘A’s Test, BPRS: Brief Psychiatric Rating Scale, CAM-(ICU): Confusion Assessment Method (Intensive Care Unit), CHART-DEL: Chart-based Delirium Identification Instrument, DMHC: Delirium Mental Health Consult, DRS: Delirium Rating Scale, DRS-R-98: Delirium Rating Scale Revised, DSM (III, IV, IV-TR, V): Diagnostic and Statistical Manual of Mental Disorders (3rd Edition, 4th Edition, 4th Edition-Text Revision, 5th Edition), ICD- (9, 9CM, 10): International Classification of Diseases (9th Revision, 9th Revision Clinical Modification, 10th Revision), MMSE: Mini-Mental State Examination, OBS Scale: Organic Brain Syndrome Scale.