Delirium in elderly patients hospitalized for acute cardiac conditions as a predictor of mortality: A systematic review and meta-analysis

ABSTRACT

Delirium is a frequent complication among elderly patients hospitalized for acute cardiac conditions. This condition is associated with an increase in both in-hospital and 30-day mortality rates. Key risk factors include advanced age, preexisting cognitive impairments, sensory deficits, depression, use of psychoactive medications, infections, and electrolyte imbalances. This review identifies existing studies on cardiac delirium as a predictor of mortality. A systematic literature search was conducted using the PRISMA guidelines on the following databases: Cochrane, PubMed, ScienceDirect, and Scopus, to identify relevant studies. Five studies were identified from 68 screened. The pooled log-effect was 0.808 (standard error = 0.154, z = 5.25, P < 0.0001), corresponding to a risk ratio of 2.24 (95% confidence interval ≈ 1.66 to 3.04). Between-study variance was τ² =0.056 (τ =0.236), indicating moderate heterogeneity, supporting a robust positive association. Cardiac delirium is not a benign complication but an early marker of vulnerability associated with increased mortality, prolonged hospitalization, and adverse short- and intermediate-term outcomes. Adoption of routine delirium screening (using validated tools) and prompt management in cardiac clinical settings, especially for high-risk groups such as older adults, is vital.