Subsyndromal Delirium in Elderly Critical Care Patients: A Meta‐Analysis of Prevalence and Risk Factors

AIMS: To determine the pooled prevalence of subsyndromal delirium (SSD) in elderly critical care patients and synthesize evidence on its modifiable risk factors through meta-analysis. STUDY DESIGN: Meta-analysis. METHODS: This meta-analysis was conducted using six databases: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and EBSCO. We assessed the quality of included studies using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality recommendation checklist. A meta-analysis of the predictive performance was conducted using the forest plot package in R 3.6.1. RESULTS: This review included 12 studies involving 2428 participants. The pooled prevalence of SSD ranged from 11.7% to 71.4%. 0.12 studies reported 19 independent risk factors associated with SSD: older age, male sex, absence of a partner, education level ≤ 9 years, lower cognitive function, comorbidities, anemia, hyponatremia, higher C-reactive protein levels, pain, fall history, complicated procedures, previous brain failure in the ICU, preoperative fasting time, number of medications, decreased grip strength, low ADL, smoking, deafness. CONCLUSION: This meta-analysis demonstrates that SSD is a common condition among elderly critical-care patients. Future investigations should employ multicenter designs with larger, more diverse patient cohorts and standardized SSD assessment protocols to enhance the robustness of evidence. IMPLICATION OF PRACTICE: This review provides updated evidence that modifiable risk factors are significantly associated with SSD in critically ill older adults. Consequently, it offers solid information to inform targeted prevention strategies and underscores the importance of early recognition by healthcare professionals in geriatric psychiatry and critical care. REPORTING METHOD: The research results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist. NO PATIENT OR PUBLICATION CONTRIBUTION: This study is a meta-analysis, and such details do not apply to our work.