Risk Factors for Delirium in Patients with Acute Heart Failure: A Systematic Review and Meta-Analysis

Delirium is an acute, potentially life-threatening condition characterized by altered attention, disorganized thinking, and changes in consciousness. It frequently occurs in hospitalized patients with acute heart failure (AHF). In this meta-analysis, we aimed to identify risk factors for delirium in patients with AHF (AHF-D). We evaluated all original studies on delirium occurrence in patients hospitalized for AHF. On March 11, 2024, we searched PubMed, Scopus, Ichushi, and the Cochrane Library. Data extracted included: first author's name, publication year, inclusion/exclusion criteria, study design, delirium assessment methods, odds ratios with 95% confidence intervals, standardized mean differences, and other relevant findings. Of 2436 screened studies, 6 met eligibility criteria (3867 patients with AHF; 796 with delirium [20.6%] and 3071 without). Risk factors for AHF-D included older age; low body mass index; the use of mechanical ventilation/noninvasive positive pressure ventilation; comorbidities (previous stroke, dementia, and depression); use of antipsychotics and benzodiazepines; and laboratory findings on admission (elevated heart rate, B-type natriuretic peptide, blood urea nitrogen, serum creatinine, and low serum albumin and sodium levels). We identified 14 risk factors for AHF-D. These findings may help clinicians identify patients at high risk of developing AHF prior to delirium onset.