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Emergency Department Stay Associated Delirium in Older Patients *

View Article: PubMed Central - PubMed

ABSTRACT

Background: Caring for older patients can be challenging in the Emergency Department (ED). A > 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium.

Methods: A historical cohort of patients who presented to a Canadian ED in 2009 and 2011 was randomly constituted. Included patients were aged ≥ 65 years old, admitted to any hospital ward, non-delirious upon arrival and had at least a 12-hour ED stay. Delirium was detected using a modified chart-based Confusion Assessment Method (CAM) tool. Hospital length of stay (LOS) was log-transformed and linear regression assessed differences between groups. Adjustments were made for age and comorbidity profile.

Results: 200 records were reviewed, 55.5% were female, median age was 78.9 yrs (SD:7.3). 36(18%) patients experienced ED-stay associated delirium. Nearly 50% of episodes started in the ED and within 36 hours of arrival. Comorbidity profile was similar between the positive CAM group and the negative CAM group. Mean adjusted hospital LOS were 20.5 days and 11.9 days respectively (p<.03).

Conclusions: 1 older adult out of 5 became delirious after a 12 hr ED stay. Since delirium increases hospital LOS by more than a week, better screening and implementation of preventing measures for delirium could reduce LOS and overcrowding in the ED.

No MeSH data available.


Related in: MedlinePlus

Length of stay for incident delirium episode (n=200)
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f1-cgj-20-10: Length of stay for incident delirium episode (n=200)

Mentions: ED-stay associated delirium significantly increases the median hospital mean LOS (Figure 1). Results of the increased hospital LOS were similar when stratified by an early onset of delirium (< 24 hrs) versus a late onset (> 24 hrs) (Figure 2). Median LOS was increased from 10.2 days (IR: 6.2–21.3) to 23.7 (10.9–49.7) in early onset group and 17.9 day (11.1–24.2) in late onset group after adjusting for age and comorbidities (p < .05).


Emergency Department Stay Associated Delirium in Older Patients *
Length of stay for incident delirium episode (n=200)
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383401&req=5

f1-cgj-20-10: Length of stay for incident delirium episode (n=200)
Mentions: ED-stay associated delirium significantly increases the median hospital mean LOS (Figure 1). Results of the increased hospital LOS were similar when stratified by an early onset of delirium (< 24 hrs) versus a late onset (> 24 hrs) (Figure 2). Median LOS was increased from 10.2 days (IR: 6.2–21.3) to 23.7 (10.9–49.7) in early onset group and 17.9 day (11.1–24.2) in late onset group after adjusting for age and comorbidities (p < .05).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Caring for older patients can be challenging in the Emergency Department (ED). A &gt; 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium.

Methods: A historical cohort of patients who presented to a Canadian ED in 2009 and 2011 was randomly constituted. Included patients were aged &ge; 65 years old, admitted to any hospital ward, non-delirious upon arrival and had at least a 12-hour ED stay. Delirium was detected using a modified chart-based Confusion Assessment Method (CAM) tool. Hospital length of stay (LOS) was log-transformed and linear regression assessed differences between groups. Adjustments were made for age and comorbidity profile.

Results: 200 records were reviewed, 55.5% were female, median age was 78.9 yrs (SD:7.3). 36(18%) patients experienced ED-stay associated delirium. Nearly 50% of episodes started in the ED and within 36 hours of arrival. Comorbidity profile was similar between the positive CAM group and the negative CAM group. Mean adjusted hospital LOS were 20.5 days and 11.9 days respectively (p&lt;.03).

Conclusions: 1 older adult out of 5 became delirious after a 12 hr ED stay. Since delirium increases hospital LOS by more than a week, better screening and implementation of preventing measures for delirium could reduce LOS and overcrowding in the ED.

No MeSH data available.


Related in: MedlinePlus