Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis.
Objective Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. Methods PubMed, EMBASE,...
| Publicado en: | Age & Ageing Vol. 53; no. 4; pp. 1 - 12 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Apr2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=176933283&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 176933283 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Apr2024 vid: 53 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 176933283 10.1093/ageing/afae073 ppf: 1 ppct: 11 formats: tig: atl: Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis. aug: au: White, Nicola Bazo-Alvarez, Juan Carlos Koopmans, Michel West, Emily Sampson, Elizabeth L affil: Marie Curie Palliative Care Research Department , Division of Psychiatry, Faculty of Brain Sciences, University College London , London , UK Research Department of Primary Care and Population Health, University College London , London , UK Escuela de Medicina, Universidad Cesar Vallejo , Trujillo , Peru Respiratory Medicine Department, Erasmus Medical Centre in Rotterdam , Rotterdam , The Netherlands e-Referrals Service, NHS England , Redditch , UK Department of Psychological Medicine, Royal London hospital, East London Foundation Trust , London , UK Centre for Psychiatry and Mental Health, Queen Mary University London , London , UK su: Hospital care of older people Old age Pain measurement Medical information storage & retrieval systems CINAHL database Meta-analysis Descriptive statistics Systematic reviews MEDLINE Odds ratio Delirium Medical databases Online information services Confidence intervals Psychology information storage & retrieval systems Evaluation sug: subj: Hospital care of older people Old age Pain measurement Medical information storage & retrieval systems CINAHL database Meta-analysis Descriptive statistics Systematic reviews MEDLINE Odds ratio Delirium Medical databases Online information services Confidence intervals Psychology information storage & retrieval systems Evaluation keyword: analgesia delirium general hospitals older people pain systematic review analgesia delirium general hospitals older people pain systematic review ab: Objective Delirium and pain are common in older adults admitted to hospital. The relationship between these is unclear, but clinically important. We aimed to systematically review the association between pain (at rest, movement, pain severity) and delirium in this population. Methods PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982–November 2022) for Medical Subject Heading terms and synonyms ('Pain', 'Analgesic', 'Delirium'). Study eligibility: (1) validated pain measure as exposure, (2) validated delirium tool as an outcome; participant eligibility: (1) medical or surgical (planned/unplanned) inpatients, (2) admission length ≥ 48 h and (3) median cohort age over 65 years. Study quality was assessed with the Newcastle Ottawa Scale. We collected/calculated odds ratios (ORs) for categorical data and standard mean differences (SMDs) for continuous data and conducted multi-level random-intercepts meta-regression models. This review was prospectively registered with PROSPERO [18/5/2020] (CRD42020181346). Results Thirty studies were selected: 14 reported categorical data; 16 reported continuous data. Delirium prevalence ranged from 2.2 to 55%. In the multi-level analysis, pain at rest (OR 2.14; 95% confidence interval [CI] 1.39–3.30), movement (OR 1.30; 95% CI 0.66–2.56), pain categorised as 'severe' (OR 3.42; 95% CI 2.09–5.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08–0.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I = 0%–77%) and continuous analyses (I = 85%). Conclusion An increase in pain was associated with a higher risk of developing delirium. Adequate pain management with appropriate analgesia may reduce incidence and severity of delirium. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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