{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:11:16Z","timestamp":1791886276558,"version":"4.3.4"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Health and Care Research ARC North Thames"},{"name":"Marie Curie Core Funding","award":["MCCC-FCO-16-U"],"award-info":[{"award-number":["MCCC-FCO-16-U"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research for Patient Benefit","award":["PB-PG-0317-20,019"],"award-info":[{"award-number":["PB-PG-0317-20,019"]}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, EMBASE, CINAHL, PsycINFO, Cochrane and Web of Science were searched (January 1982\u2013November 2022) for Medical Subject Heading terms and synonyms (\u2018Pain\u2019, \u2018Analgesic\u2019, \u2018Delirium\u2019). 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\u2009\u2265\u200948\u00a0h and (3) median cohort age over 65\u00a0years. 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u20133.30), movement (OR 1.30; 95% CI 0.66\u20132.56), pain categorised as \u2018severe\u2019 (OR 3.42; 95% CI 2.09\u20135.59) and increased pain severity when measured continuously (SMD 0.33; 95% CI 0.08\u20130.59) were associated with an increased delirium risk. There was substantial heterogeneity in both categorical (I2\u2009=\u20090%\u201377%) and continuous analyses (I2\u2009=\u200985%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afae073","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T12:06:50Z","timestamp":1711800410000},"source":"Crossref","is-referenced-by-count":42,"title":["Understanding the association between pain and delirium in older hospital inpatients: systematic review and meta-analysis"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7438-0072","authenticated-orcid":false,"given":"Nicola","family":"White","sequence":"first","affiliation":[{"name":"Marie Curie Palliative Care Research Department , Division of Psychiatry, Faculty of Brain Sciences, , London , UK"},{"name":"University College London , Division of Psychiatry, Faculty of Brain Sciences, , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Bazo-Alvarez","sequence":"additional","affiliation":[{"name":"Research Department of Primary Care and Population Health, University College London , London , UK"},{"name":"Escuela de Medicina, Universidad Cesar Vallejo , Trujillo , Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Koopmans","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Department, Erasmus Medical Centre in Rotterdam , Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"West","sequence":"additional","affiliation":[{"name":"e-Referrals Service, NHS England , Redditch , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L","family":"Sampson","sequence":"additional","affiliation":[{"name":"Marie Curie Palliative Care Research Department , Division of Psychiatry, Faculty of Brain Sciences, , London , UK"},{"name":"University College London , Division of Psychiatry, Faculty of Brain Sciences, , London , UK"},{"name":"Department of Psychological Medicine, Royal London hospital, East London Foundation Trust , London , UK"},{"name":"Centre for Psychiatry and Mental Health, Queen Mary University London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"key":"2024041301484532000_ref1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","article-title":"Delirium in elderly people","volume":"383","author":"Inouye","year":"2014","journal-title":"Lancet"},{"key":"2024041301484532000_ref2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.2106\/JBJS.N.00724","article-title":"Health economic implications of perioperative delirium in older patients after surgery for a fragility hip fracture","volume":"97","author":"Zywiel","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"2024041301484532000_ref3","doi-asserted-by":"crossref","first-page":"e0123090","DOI":"10.1371\/journal.pone.0123090","article-title":"Efficacy of non-pharmacological interventions to prevent and treat delirium in older patients: a systematic overview. 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