{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:58Z","timestamp":1787017078065,"version":"build-2736575974"},"reference-count":70,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,15]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the incidence of delirium and its predictors among adult patients admitted to the intensive care units of comprehensive specialised hospitals in the Amhara region of northwest Ethiopia from 18 October 2024 to 20 February 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A multicentre prospective observational study was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Four comprehensive specialised hospitals in the Amhara region of northwest Ethiopia, from 18 October 2024 to 20 February 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 351 patients were included in the final analysis during the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The primary outcome measure of this study was the incidence of delirium. Additionally, the study investigated the factors associated with delirium incidence among adult patients admitted to intensive care units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The incidence of delirium among adult patients in intensive care units was 42.17% (95% CI: 37.08 to 47.42). Pain (adjusted HR (AHR) = 4.74; 95% CI: 2.38 to 9.44), mechanical ventilation (AHR = 2.96; 95% CI: 1.56 to 5.63), age 65 years or older (AHR = 2.18; 95% CI: 1.48 to 3.21) and agitation (Richmond Agitation-Sedation Scale (RASS) \u22651) (AHR = 3.26; 95% CI: 2.09 to 5.09) were statistically significant factors associated with delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and recommendation<\/jats:title>\n                    <jats:p>In the present study, more than one-third of patients developed delirium. Pain, mechanical ventilation, age 65 or older and agitation (RASS\u22651) were significantly associated with delirium occurrence. To reduce the incidence of delirium, the current study recommends treating or preventing pain and agitation. Additionally, special attention should be given to patients receiving mechanical ventilation and those aged 65 or older during care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103581","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T13:15:29Z","timestamp":1757078129000},"page":"e103581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Incidence and predictors of delirium in patients admitted to intensive care unit at comprehensive specialised hospitals in Amhara region, northwest Ethiopia: a multicentre prospective observational study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0462-8299","authenticated-orcid":false,"given":"Temesgen Brilie","family":"Asmare","sequence":"first","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habtie Bantider","family":"Wubet","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negesse Zurbachew","family":"Gobezie","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1463-3222","authenticated-orcid":false,"given":"Getachew Mekete","family":"Deress","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-1285","authenticated-orcid":false,"given":"Kumlachew Geta","family":"Belete","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molla Amsalu","family":"Tadesse","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8452-3436","authenticated-orcid":false,"given":"Abere Gebru","family":"Abuhay","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0708-4891","authenticated-orcid":false,"given":"Biruk","family":"Demissie","sequence":"additional","affiliation":[{"name":"Department of Environmental health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0658-4628","authenticated-orcid":false,"given":"Amanu Addis","family":"Melesew","sequence":"additional","affiliation":[{"name":"Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8839-8963","authenticated-orcid":false,"given":"Walelign Asmie","family":"Afework","sequence":"additional","affiliation":[{"name":"Department of Adult Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2672-5002","authenticated-orcid":false,"given":"Yewlsew Fentie","family":"Alle","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Getaneh","family":"Demite","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diriba","family":"Teshome","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaletsidk Dessalegn","family":"Mossie","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belayneh Dessie","family":"Kassa","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Debre Tabor University, Debre Tabor, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3584-4545","authenticated-orcid":false,"given":"Gezahagn Demsu","family":"Gedefaw","sequence":"additional","affiliation":[{"name":"Department of Neonatal Health Nursing, School of Nursing, College of Medicine and Health Sciences, and Specialized Hospital, University of Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"2025090506151578000_15.9.e103581.1","article-title":"Patient Outcomes and Management Strategies for Intensive Care Unit (ICU)-Associated Delirium: A Literature Review","volume":"16","author":"Abdelbaky","year":"2024","journal-title":"Cureus"},{"key":"2025090506151578000_15.9.e103581.2","doi-asserted-by":"crossref","first-page":"103473","DOI":"10.1016\/j.iccn.2023.103473","article-title":"Anxiety and depression in intensive care patients six months after admission to an intensive care unit: A cohort study","volume":"78","author":"Bj\u00f8rn\u00f8y","year":"2023","journal-title":"Intensive Crit Care Nurs"},{"key":"2025090506151578000_15.9.e103581.3","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S2213-2600(19)30203-6","article-title":"Post-traumatic stress in the intensive care unit","volume":"7","author":"Burki","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2025090506151578000_15.9.e103581.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2017.07.008"},{"key":"2025090506151578000_15.9.e103581.5","first-page":"156","volume-title":"Handbook of old age liaison psychiatry","volume":"2024","author":"Krishnan","year":"2024"},{"key":"2025090506151578000_15.9.e103581.6","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1038\/s41572-020-00223-4","article-title":"Delirium","volume":"6","author":"Wilson","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"2025090506151578000_15.9.e103581.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000284506.43390.F3"},{"key":"2025090506151578000_15.9.e103581.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h2538","article-title":"Outcome of delirium in critically ill patients: systematic review and meta-analysis","volume":"350","author":"Salluh","year":"2015","journal-title":"BMJ"},{"key":"2025090506151578000_15.9.e103581.9","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s40560-015-0118-z","article-title":"Incidence and risk factors of delirium in multi-center Thai surgical intensive care units: a prospective cohort study","volume":"3","author":"Pipanmekaporn","year":"2015","journal-title":"J Intensive Care"},{"key":"2025090506151578000_15.9.e103581.10","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.aucc.2018.02.002","article-title":"Effect of organisational factors on the variation in incidence of delirium in intensive care unit patients: A systematic review and meta-regression analysis","volume":"31","author":"Rood","year":"2018","journal-title":"Aust Crit Care"},{"key":"2025090506151578000_15.9.e103581.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2012.06.009"},{"key":"2025090506151578000_15.9.e103581.12","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5507\/bp.2017.004","article-title":"Incidence and risk factors for delirium development in ICU patients - a prospective observational study","volume":"161","author":"Kanova","year":"2017","journal-title":"Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub"},{"key":"2025090506151578000_15.9.e103581.13","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/6219678","article-title":"Incidence and Risk Factors of Delirium in the Intensive Care Unit: A Prospective Cohort","volume":"2021","author":"Rahimi-Bashar","year":"2021","journal-title":"Biomed Res Int"},{"key":"2025090506151578000_15.9.e103581.14","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1111\/nicc.12857","article-title":"Incidence, prevalence and risk factors of delirium in ICU patients: A systematic review and meta\u2010analysis","volume":"28","author":"Wu","year":"2023","journal-title":"Nurs Crit Care"},{"key":"2025090506151578000_15.9.e103581.15","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"2025090506151578000_15.9.e103581.16","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-024-07404-9"},{"key":"2025090506151578000_15.9.e103581.17","article-title":"Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings","volume":"11","author":"Miranda","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090506151578000_15.9.e103581.18","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a00118"},{"key":"2025090506151578000_15.9.e103581.19","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182783b72"},{"key":"2025090506151578000_15.9.e103581.20","first-page":"1611","article-title":"Prevention of delirium in the intensive care unit","volume":"144","author":"Braune","year":"2019","journal-title":"Dtsch Med Wochenschr"},{"key":"2025090506151578000_15.9.e103581.21","article-title":"Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients","volume":"7","author":"Burton","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090506151578000_15.9.e103581.22","doi-asserted-by":"crossref","first-page":"635","DOI":"10.21608\/ejhc.2024.356403","article-title":"Relation between Delirium Symptoms and Patients\u2019 Outcomes during the Postoperative Period in Intensive Care Units","volume":"15","author":"ElshrabasyAbd- Elghaffar","year":"2024","journal-title":"Egyptian Journal of Health Care"},{"key":"2025090506151578000_15.9.e103581.23","doi-asserted-by":"crossref","unstructured":"Lehman R , Jawaid S , Lindroth H , et al . The Relationship Between Intensive Care Unit (ICU) Delirium Severity and 2-Year Mortality. IMPRS 2023;6. doi:10.18060\/27869","DOI":"10.18060\/27869"},{"key":"2025090506151578000_15.9.e103581.24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025090506151578000_15.9.e103581.25","doi-asserted-by":"crossref","unstructured":"Habtamu A , Mezgebu T , Workina A , et al . Incidence and predictors of delirium among the intensive care unit patients at Jimma Medical Center, Southwest Ethiopia. FEM 2024. doi:10.18502\/fem.v8i4.17082","DOI":"10.18502\/fem.v8i4.17082"},{"key":"2025090506151578000_15.9.e103581.26","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31829a6f1e"},{"key":"2025090506151578000_15.9.e103581.27","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1590\/S1516-31802008000400003","article-title":"Validity, reliability and applicability of Portuguese versions of sedation-agitation scales among critically ill patients","volume":"126","author":"Nassar Junior","year":"2008","journal-title":"Sao Paulo Med J"},{"key":"2025090506151578000_15.9.e103581.28","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2107138"},{"key":"2025090506151578000_15.9.e103581.29","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181c3119e"},{"key":"2025090506151578000_15.9.e103581.30","unstructured":"Butterworth JF , Mackey DC , Wasnick JD . Morgan and mikhail\u2019s clinical anesthesiology cases. McGraw Hill Professional, 2020."},{"key":"2025090506151578000_15.9.e103581.31","doi-asserted-by":"crossref","unstructured":"Reddi AS . Fluid, electrolyte and acid-base disorders. Cham, Switzerland: Springer, 2018:391\u2013401.","DOI":"10.1007\/978-3-319-60167-0_30"},{"key":"2025090506151578000_15.9.e103581.32","article-title":"A Comprehensive Review of Chloride Management in Critically Ill Patients","volume":"16","author":"Sagar","year":"2024","journal-title":"Cureus"},{"key":"2025090506151578000_15.9.e103581.33","article-title":"Prognostic Significance of Serum Chloride Levels in Congestive Heart Failure","volume":"14","author":"Singh","year":"2023","journal-title":"Chest"},{"key":"2025090506151578000_15.9.e103581.34","doi-asserted-by":"crossref","unstructured":"Walker DH . Principles of Diagnosis of Infectious Diseases. Pathobiology of Human Disease 2014;222\u20135. doi:10.1016\/B978-0-12-386456-7.01713-5","DOI":"10.1016\/B978-0-12-386456-7.01713-5"},{"key":"2025090506151578000_15.9.e103581.35","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4103\/ijccm.IJCCM_244_17","article-title":"Delirium in the Intensive Care Unit: Incidence, risk factors, and impact on outcome","volume":"22","author":"Tilouche","year":"2018","journal-title":"Indian J Crit Care Med"},{"key":"2025090506151578000_15.9.e103581.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2009.08.005"},{"key":"2025090506151578000_15.9.e103581.37","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1590\/S0080-623420160000500007","article-title":"Incidence and factors related to delirium in an intensive care unit","volume":"50","author":"Mori","year":"2016","journal-title":"Rev Esc Enferm USP"},{"key":"2025090506151578000_15.9.e103581.38","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2021.42.4.20200754"},{"key":"2025090506151578000_15.9.e103581.39","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/jocn.16197","article-title":"Incidence, characteristics and risk factors of delirium in the intensive care unit: An observational study","volume":"32","author":"Erbay Dalli","year":"2023","journal-title":"J Clin Nurs"},{"key":"2025090506151578000_15.9.e103581.40","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2020-000564","article-title":"Incidence and risk factors of delirium in surgical intensive care unit","volume":"6","author":"Ali","year":"2021","journal-title":"Trauma Surg Acute Care Open"},{"key":"2025090506151578000_15.9.e103581.41","doi-asserted-by":"crossref","DOI":"10.1186\/s11556-019-0224-3","article-title":"Small samples and increased variability - discussing the need for restricted types of randomization in exercise interventions in old age","volume":"16","author":"Netz","year":"2019","journal-title":"Eur Rev Aging Phys Act"},{"key":"2025090506151578000_15.9.e103581.42","doi-asserted-by":"crossref","DOI":"10.1186\/cc11407","article-title":"The confusion assessment method for the intensive care unit (CAM-ICU) and intensive care delirium screening checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies","volume":"16","author":"Gusmao-Flores","year":"2012","journal-title":"Crit Care"},{"key":"2025090506151578000_15.9.e103581.43","article-title":"Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study","volume":"2015","author":"Kwizera","year":"2015","journal-title":"Crit Care Res Pract"},{"key":"2025090506151578000_15.9.e103581.44","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1111\/nicc.12526","article-title":"Prevalence and risk factors of delirium in the intensive care unit: An observational study","volume":"26","author":"Gravante","year":"2021","journal-title":"Nurs Crit Care"},{"key":"2025090506151578000_15.9.e103581.45","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1007\/s12028-021-01309-x","article-title":"Pathophysiology of Brain Injury and Neurological Outcome in Acute Respiratory Distress Syndrome: A Scoping Review of Preclinical to Clinical Studies","volume":"35","author":"Huang","year":"2021","journal-title":"Neurocrit Care"},{"key":"2025090506151578000_15.9.e103581.46","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1186\/s13054-021-03778-0","article-title":"Brain-lung interactions and mechanical ventilation in patients with isolated brain injury","volume":"25","author":"Ziaka","year":"2021","journal-title":"Crit Care"},{"key":"2025090506151578000_15.9.e103581.47","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202010-3794OC"},{"key":"2025090506151578000_15.9.e103581.48","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-4063-z"},{"key":"2025090506151578000_15.9.e103581.49","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f2304","article-title":"Influence of trial sample size on treatment effect estimates: meta-epidemiological study","volume":"346","author":"Dechartres","year":"2013","journal-title":"BMJ"},{"key":"2025090506151578000_15.9.e103581.50","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1177\/1054773820973123","article-title":"Evaluating Pain, Opioids, and Delirium in Critically Ill Older Adults","volume":"30","author":"Pavone","year":"2021","journal-title":"Clin Nurs Res"},{"key":"2025090506151578000_15.9.e103581.51","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2024.1446523","article-title":"Mechanisms underlying delirium in patients with critical illness","volume":"16","author":"Fan","year":"2024","journal-title":"Front Aging Neurosci"},{"key":"2025090506151578000_15.9.e103581.52","doi-asserted-by":"publisher","DOI":"10.4266\/acc.2022.00094"},{"key":"2025090506151578000_15.9.e103581.53","doi-asserted-by":"publisher","DOI":"10.1097\/NCI.0b013e31822052cb"},{"key":"2025090506151578000_15.9.e103581.54","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1186\/s12913-020-05497-8","article-title":"Associations between stressors and difficulty sleeping in critically ill patients admitted to the intensive care unit: a cohort study","volume":"20","author":"Miranda-Ackerman","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"2025090506151578000_15.9.e103581.55","doi-asserted-by":"crossref","DOI":"10.1186\/s12871-021-01259-z","article-title":"Development and validation of a predictive score for ICU delirium in critically ill patients","volume":"21","author":"Zhang","year":"2021","journal-title":"BMC Anesthesiol"},{"key":"2025090506151578000_15.9.e103581.56","doi-asserted-by":"crossref","DOI":"10.1016\/j.conctc.2024.101263","article-title":"Decreasing the incidence of delirium via multi-sensory stimulation in patients receiving mechanical ventilation in the intensive care unit: A protocol for a randomized feasibility study","volume":"38","author":"He","year":"2024","journal-title":"Contemp Clin Trials Commun"},{"key":"2025090506151578000_15.9.e103581.57","doi-asserted-by":"publisher","DOI":"10.1177\/1049732311421616"},{"key":"2025090506151578000_15.9.e103581.58","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1007\/s00134-013-3034-5","article-title":"Effect of sedation level on the prevalence of delirium when assessed with CAM-ICU and ICDSC","volume":"39","author":"Haenggi","year":"2013","journal-title":"Intensive Care Med"},{"key":"2025090506151578000_15.9.e103581.59","doi-asserted-by":"crossref","DOI":"10.1186\/s12890-022-02052-5","article-title":"Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study","volume":"22","author":"Fu","year":"2022","journal-title":"BMC Pulm Med"},{"key":"2025090506151578000_15.9.e103581.60","doi-asserted-by":"crossref","DOI":"10.1097\/jnr.0000000000000384","article-title":"Incidence and Risk Factors for Delirium in Older Patients Following Intensive Care Unit Admission: A Prospective Observational Study","volume":"28","author":"Li","year":"2020","journal-title":"J Nurs Res"},{"key":"2025090506151578000_15.9.e103581.61","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.49950","article-title":"Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review","volume":"6","author":"Ormseth","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2025090506151578000_15.9.e103581.62","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1605501"},{"key":"2025090506151578000_15.9.e103581.63","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318192fcf9"},{"key":"2025090506151578000_15.9.e103581.64","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1097\/CCM.0000000000001094","article-title":"Anticholinergic Medication Use and Transition to Delirium in Critically Ill Patients: A Prospective Cohort Study","volume":"43","author":"Wolters","year":"2015","journal-title":"Crit Care Med"},{"key":"2025090506151578000_15.9.e103581.65","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1177\/00031348241241707","article-title":"Incidence and Risk Factors for ICU-Associated Delirium in the Alert Geriatric Trauma Population","volume":"90","author":"Ulderich Williams","year":"2024","journal-title":"Am Surg"},{"key":"2025090506151578000_15.9.e103581.66","article-title":"Relationship Between Serum Norepinephrine Levels at ICU Admission and the Risk of ICU-Acquired Delirium: Secondary Analysis of the Melatonin Evaluation of Lowered Inflammation of ICU Trial","volume":"2","author":"Yasuda","year":"2020","journal-title":"Crit Care Explor"},{"key":"2025090506151578000_15.9.e103581.67","doi-asserted-by":"crossref","first-page":"407","DOI":"10.4266\/acc.2022.00164","article-title":"The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units","volume":"37","author":"Kim","year":"2022","journal-title":"Acute Crit Care"},{"key":"2025090506151578000_15.9.e103581.68","article-title":"Hypoactive Delirium: Differential Diagnosis, Evaluation, and Treatment","volume":"26","author":"Rosen","year":"2024","journal-title":"Prim Care Companion CNS Disord"},{"key":"2025090506151578000_15.9.e103581.69","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.aucc.2019.12.002","article-title":"Influence of sedation on delirium recognition in critically ill patients: A multinational cohort study","volume":"33","author":"van den Boogaard","year":"2020","journal-title":"Aust Crit Care"},{"key":"2025090506151578000_15.9.e103581.70","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7280.226"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-103581","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T13:15:35Z","timestamp":1757078135000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-103581"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":70,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bmjopen-2025-103581"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-103581","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}