{"doi":"10.1371/journal.pone.0246330","title":"Delirium as a predictor of mortality and disability among hospitalized patients in Zambia","abstract":"OBJECTIVE: To study the epidemiology and outcomes of delirium among hospitalized patients in Zambia. METHODS: We conducted a prospective cohort study at the University Teaching Hospital in Lusaka, Zambia, from October 2017 to April 2018. The primary exposure was delirium duration over the initial 3 days of hospitalization, assessed daily using the Brief Confusion Assessment Method. The primary outcome was 6-month mortality. Secondary outcomes included 6-month disability, evaluated using the World Health Organization Disability Assessment Schedule 2.0. FINDINGS: 711 adults were included (median age, 39 years; 461 men; 459 medical, 252 surgical; 323 with HIV). Delirium prevalence was 48.5% (95% CI, 44.8%-52.3%). 6-month mortality was higher for delirious participants (44.6% [39.3%-50.1%]) versus non-delirious participants (20.0% [15.4%-25.2%]; P < .001). After adjusting for covariates, delirium duration independently predicted 6-month mortality and disability with a significant dose-response association between number of days with delirium and odds of worse clinical outcome. Compared to no delirium, presence of 1, 2 or 3 days of delirium resulted in odds ratios for 6-month mortality of 1.43 (95% CI, 0.73-2.80), 2.20 (1.07-4.51), and 3.92 (2.24-6.87), respectively (P < .001). Odds of 6-month disability were 1.20 (0.70-2.05), 1.73 (0.95-3.17), and 2.80 (1.78-4.43), respectively (P < .001). CONCLUSION: Among hospitalized medical and surgical patients in Zambia, delirium prevalence was high and delirium duration independently predicted mortality and disability at 6 months. This work lays the foundation for prevention, detection, and management of delirium in low-income countries. Long-term follow up of outcomes of critical illness in resource-limited settings appears feasible using the WHO Disability Assessment Schedule.","journal":"PLoS ONE","year":2021,"id":173140,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":24,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9248,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":710227,"name":"Kondwelani Mateyo","orcid":"0000-0002-1498-7120","position":1,"is_corresponding":false},{"id":710228,"name":"Li Wang","orcid":"0000-0002-4282-2454","position":2,"is_corresponding":false},{"id":105980,"name":"Christopher J. Lindsell","orcid":"0000-0002-3297-2811","position":3,"is_corresponding":false},{"id":651506,"name":"Elisabeth D. Riviello","orcid":"0000-0002-9443-3928","position":4,"is_corresponding":false},{"id":381409,"name":"Deanna Saylor","orcid":"0000-0002-9297-0244","position":5,"is_corresponding":false},{"id":289268,"name":"Douglas C. Heimburger","orcid":"0000-0003-3551-9710","position":6,"is_corresponding":false},{"id":106792,"name":"E. Wesley Ely","orcid":"0000-0003-3957-2172","position":7,"is_corresponding":false},{"id":710226,"name":"Justin K. Banerdt","orcid":"0000-0003-3395-1673","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-18T23:46:45.768135Z","pmid":"33571227","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}