What is the incidence of unrecognized delirium in emergency departments and its impact on resources, patient function, and cognition at 60 days?

BEEM Bottom Line

Why is this study important?

Delirium in emergency department (ED) patients is prevalent, harmful, and detectable. Delirium is a neuropsychiatric dysfunction characterized by a sudden onset, waxing and waning course, inattention, disorganized thinking, and changes in level of consciousness. According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition, changes in cognition in delirium are not attributable to established neurocognitive disorder, but they are direct consequences of other medical conditions. Hypoactive delirium, the most common subtype encountered in the ED, is associated with the highest mortality and is missed by emergency medicine providers in 57–83% of cases.[1] [2] Delirium under-recognition in the ED is associated with increased 6-month mortality and prolonged hospital length-of-stay (LOS). Currently, there is no conscensus on which delirium screening methods are most appropriate to use in the ED.[3]

Which, if any, threats to validity are most likely to have an impact on the results and how?

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