ICU sedation, delirium & recovery
Prevalence and incidence of ICU delirium and pain: a systematic review and meta-analysis
Authors' conclusion
Delirium and pain prevalence among adults admitted to ICUs have decreased since publication of pain, agitation and delirium guidelines. However, both remain common, occurring in up to one-half of patients.
Study context
- Population
- Critically ill adults in the ICU
- Participants
- 183,285 adults · 213 studies
- Outcome
- Prevalence and incidence of ICU delirium and pain
Methodological detailsrandom effects meta-analysis, randomised or observational studies, Freeman-Tukey double arcsine transformation; Joanna Briggs' Institute prevalence checklist for risk of bias
- Random effects meta-analysis
- Randomised or observational studies
- Freeman-Tukey double arcsine transformation; Joanna Briggs' Institute prevalence checklist for risk of bias
Pooled result
As reported in the abstract
ICU delirium and pain prevalence and incidence
Pooled delirium prevalence (173 studies), 95%CI 32.4-39.0%
35.7%
Pooled delirium incidence (41 studies), 95%CI 23.2-34.8%
28.8%
Pooled pain prevalence (11 studies), 95%CI 28.6-58.9%
43.5%
Further pooled results
| Outcome | Before | After | P value |
|---|---|---|---|
| Delirium prevalence before vs after 2013 | 39.9% (95% CI 34.7–45.3%) | 32.3% (95% CI 28.2–36.5%) | P = 0.02 |
| Pain prevalence before vs after 2013 pain, agitation and delirium guidelines | 64.6% (95% CI 41.6–84.6%) | 35.8% (95% CI 20.5–52.6%) | P = 0.046 |
Most common delirium subtype: hypoactive
- Hypoactive delirium, 95%CI 12.1-21.4%
- 16.5%
Delirium prevalence before vs after 2013
- Delirium incidence did not decrease since 2013
Original publication
Prevalence and incidence of ICU delirium and pain: a systematic review and meta-analysis. Intensive Care Med. Published 21 October 2025. doi:10.
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