Journal article
ACR Appropriateness Criteria® Altered Mental Status, Coma, Delirium, and Psychosis: 2024 Update
Journal of the American College of Radiology, Vol.21(11), pp.S372-S383
11/2024
DOI: 10.1016/j.jacr.2024.08.018
Abstract
Altered mental status (AMS) and coma are terms used to describe disorders of arousal and content of consciousness. AMS may account for up to 4% to 10% of chief complaints in the emergency department setting and is a common accompanying symptom for other presentations. AMS is not a diagnosis, but rather a term for symptoms of acute or chronic disordered mentation, including confusion, disorientation, lethargy, drowsiness, somnolence, unresponsiveness, agitation, altered behavior, inattention, hallucinations, delusions, and psychosis. Some of the most common disorders associated with AMS are underlying medical conditions, substance use, and mental disorders. This document focuses on the appropriateness of neuroimaging in adult patients presenting with AMS changes including new onset delirium or new onset psychosis. In these cases, imaging is often expedited for initial stabilization and to exclude an intracranial process requiring intervention.
The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
Details
- Title: Subtitle
- ACR Appropriateness Criteria® Altered Mental Status, Coma, Delirium, and Psychosis: 2024 Update
- Creators
- Bruno P. Soares - Stanford University School of MedicineRobert Y. Shih - Uniformed Services University of the Health SciencesPallavi S. Utukuri - Columbia University Irving Medical CenterMegan AdamsonMatthew J. Austin - University of Virginia Health SystemRichard K.J. Brown - University of Michigan–Ann ArborJudah Burns - Montefiore Medical CenterKelsey Cacic - San Antonio Military Medical CenterSammy Chu - University of British ColumbiaCathy Crone - Inova Fairfax HospitalJana Ivanidze - Weill Cornell MedicineChristopher D. Jackson - University of Tennessee Health Science CenterAleks Kalnins - University of ChicagoChristopher A. Potter - Brigham and Women's HospitalSonja Rosen - Cedars-Sinai Medical CenterKarl A. Soderlund - Naval Medical Center PortsmouthAshesh A. Thaker - University of Colorado Anschutz Medical CampusLily L. Wang - University of Cincinnati Medical CenterBruno Policeni - University of IowaExpert Panel on Neurological Imaging
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Radiology, Vol.21(11), pp.S372-S383
- Publisher
- Elsevier Inc; NEW YORK
- DOI
- 10.1016/j.jacr.2024.08.018
- ISSN
- 1546-1440
- eISSN
- 1558-349X
- Language
- English
- Date published
- 11/2024
- Academic Unit
- Radiology; Oral Pathology, Radiology and Medicine; Otolaryngology
- Record Identifier
- 9984738165602771
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