The following is a summary of “Association of delirium with increased short-term mortality among older emergency department patients: A cohort study,” published in the April 2023 issue of Emergency Medicine by Arneson, et al.

For a study, researchers sought to investigate the association between delirium and short-term mortality in geriatric patients who presented to the emergency department (ED).

Adults aged ≥75 years, who were screened for delirium during their ED visit, were included in the study. The Delirium Triage Screen and the Brief Confusion Assessment Method were used to diagnose delirium. In-hospital, 7-day, and 30-day mortality were compared between patients with and without ED delirium. Logistic regression was used to calculate odds ratios (ORs) with 95% CIs after adjusting for confounding factors, including age, sex, history of dementia, ED disposition, and acuity.

The study analyzed 967 ED visits, among which 107 (11.1%) were detected with delirium. The median age of the cohort was 83 years, with 526 (54.4%) females, 285 (29.5%) with documented dementia, and 171 (17.7%) with high acuity Emergency Severity Index triage level 1 or 2. During hospitalization, 5/107 (4.7%) of patients with delirium and 4/860 (0.5%) of patients without delirium died. Within 7 days of ED discharge, 6/107 (5.6%) of patients with delirium and 6/860 (0.7%) of patients without delirium died (unadjusted OR 8.46, 95% CI 2.68–26.71). Within 30 days, 18/107 (16.8%) of patients with delirium and 37/860 (4.3%) of patients without delirium died (unadjusted OR 4.50, 95% CI 2.46–8.23). ED delirium remained associated with higher 7-day (adjusted OR 5.23, 95% CI 1.44–19.05, P = 0.008) and 30-day mortality (adjusted OR 2.82, 95% CI 1.45–5.46, P = 0.002).

The study demonstrated that delirium was a significant prognostic factor for short-term mortality in geriatric patients who present to the ED. Healthcare professionals should be aware of this association and optimize prevention, management, disposition, and communication with patients and their families accordingly.

Reference: sciencedirect.com/science/article/abs/pii/S073567572300044X