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Analyzing Incidence and Risk Factors for Delirium in Non-Intensive Care Pediatric Patients
Simi George1,2, Brett Leingang1,2, Larissa Dean2
1Corewell Health/Helen Devos Children's Hospital, Grand Rapids, Michigan.
Hospital Pediatrics
|April 23, 2026
Summary
Approximately one-third of pediatric patients screened positive for delirium, with sepsis and certain medications identified as key risk factors. Early detection and understanding these factors are crucial for improved patient outcomes.
Area of Science:
- Pediatric Medicine
- Critical Care Medicine
- Neuroscience
Background:
- Delirium is a common complication in hospitalized children, often underdiagnosed outside of intensive care settings.
- Early identification and management of delirium are essential for improving patient outcomes and reducing healthcare costs.
Purpose of the Study:
- To determine the incidence of delirium in non-intensive care pediatric inpatient settings.
- To identify clinical risk factors associated with the development of delirium in this population.
Main Methods:
- A single-center retrospective study was conducted on general pediatric floors.
- Patients screened positive using the Cornell Assessment of Pediatric Delirium (CAPD) tool between September 2022 and January 2024.
- Delirium diagnosis was confirmed by a two-person clinical team using DSM-5 criteria based on retrospective data; logistic regression analyzed risk factors.
Main Results:
- Out of 245 patients with positive CAPD scores, 83 (33.9%) were diagnosed with delirium.
- Only 13.3% of these delirium cases were diagnosed during hospitalization.
- Risk factors included exposure to midazolam, diphenhydramine, hydroxyzine, sepsis diagnosis, and length of stay >5 days.
Conclusions:
- One-third of pediatric patients screening positive for delirium on general medical floors exhibited symptoms consistent with delirium.
- Sepsis, prolonged hospital stay, and exposure to specific sedatives/antihistamines are significant risk factors.
- Further research should focus on enhancing delirium screening tools and elucidating the role of identified risk factors.
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