• Guy H M Stanley, Angus R J Barber, Aoife M O'Brien, Cheryl Hamill, Glenn Boardman, Cody C Frear, Dale W Edgar, Hannah Seymour, and Fiona M Wood.
• Burn Injury Research Unit, University of Western Australia, Crawley, Western Australia, Australia; State Adult Burn Unit, Fiona Stanley Hospital, SMHS, Western Australia, Australia. Electronic address: guy.stanley@health.wa.gov.au.
• Burns. 2022 Aug 1; 48 (5): 1040-1054.

IntroductionDelirium is a potentially modifiable, acutely altered mental state, commonly characterised as a hospital-acquired complication. Studies of adult inpatients with acute burns with and without delirium identify causative risks related to the injury or treatment and outcomes related to the patient and healthcare system. We compare patients with and without delirium, providing a high-level quantitative synthesis of delirium risks and outcomes to inform guidelines and future research.MethodsA systematic review, meta-analysis and GRADE evaluation of risks and outcomes associated with delirium in adults with acute burns was conducted using PRISMA guidelines and PROSPERO protocol CRD42021283055. The Newcastle-Ottawa Scale was used to assess quality.ResultsInvestigators reviewed ten studies. ASA score ≥ 3, Total Body Surface Area Percentage (TBSA)> 10%, surgery done, ICU admission, hospital and also Intensive Care Unit (ICU) lengths of stay all had statistically significant associations with delirium, with low-very low certainty on GRADE evaluation. Limitations were heterogeneous studies, review methodology and study bias.ConclusionDelirium represents a significant risk to comorbid patients with burns that are hospitalised, receive ICU care, and surgery. Further research is indicated to precisely categorise delirium along the clinical journey to identify modifiable factors, prevention, and proactive therapy.Copyright © 2022 Elsevier Ltd and ISBI. All rights reserved.

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