Delirium, confusion, or altered mental status as a risk for abnormal head computed tomogram findings in older adults in the emergency department: A Geriatric Emergency Department Guidelines 2.0 systematic review and meta-analysis

Sangil Lee; Faithe R. Cavalier; Jane M. Hayes; Michelle Doering; Alexander X. Lo; Danya Khoujah; Matthew A. Howard; Kerstin de Wit; Shan W. Liu

doi:10.1016/j.ajem.2023.06.034

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Delirium, confusion, or altered mental status as a risk for abnormal head computed tomogram findings in older adults in the emergency department: A Geriatric Emergency Department Guidelines 2.0 systematic review and meta-analysis

Journal article

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Delirium, confusion, or altered mental status as a risk for abnormal head computed tomogram findings in older adults in the emergency department: A Geriatric Emergency Department Guidelines 2.0 systematic review and meta-analysis

Sangil Lee, Faithe R. Cavalier, Jane M. Hayes, Michelle Doering, Alexander X. Lo, Danya Khoujah, Matthew A. Howard, Kerstin de Wit and Shan W. Liu

The American journal of emergency medicine, Vol.71, pp.190-194

09/2023

DOI: 10.1016/j.ajem.2023.06.034

PMID: 37423026

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Abstract

Altered mental status (including delirium) is a common presentations among older adults to the emergency department (ED). We aimed to report the association between altered mental status in older ED patients and acute abnormal findings on head computed tomogram (CT). A systematic review was conducted using Ovid Medline, Embase, Clinicaltrials.gov, Web of Science, and Cochrane Central from conception to April 8th, 2021. We included citations if they described patients aged 65 years or older who received head imaging at the time of ED assessment, and reported whether patients had delirium, confusion, or altered mental status. Screening, data extraction, and bias assessment were performed in duplicate. We estimated the odds ratios (OR) for abnormal neuroimaging in patients with altered mental status. The search strategy identified 3031 unique citations, of which two studies reporting on 909 patients with delirium, confusion or altered mental status were included. No identified study formally assessed for delirium. The OR for abnormal head CT findings in patients with delirium, confusion or altered mental status was 0.35 (95% CI 0.031 to 3.97) compared to patients without delirium, confusion or altered mental status. We did not find a statistically significant association between delirium, confusion or altered mental status and abnormal head CT findings in older ED patients.

Altered mental status

Delirium

Head CT

Details

Title: Subtitle: Delirium, confusion, or altered mental status as a risk for abnormal head computed tomogram findings in older adults in the emergency department: A Geriatric Emergency Department Guidelines 2.0 systematic review and meta-analysis
Creators: Sangil Lee - University of Iowa
Faithe R. Cavalier - University of Iowa
Jane M. Hayes - Harvard Affiliated Emergency Medicine Residency
Michelle Doering - Washington University in St. Louis
Alexander X. Lo - Northwestern University
Danya Khoujah - AdventHealth Tampa
Matthew A. Howard - University of Iowa
Kerstin de Wit - McMaster University
Shan W. Liu - Massachusetts General Hospital
Resource Type: Journal article
Publication Details: The American journal of emergency medicine, Vol.71, pp.190-194
DOI: 10.1016/j.ajem.2023.06.034
PMID: 37423026
NLM abbreviation: Am J Emerg Med
ISSN: 0735-6757
eISSN: 1532-8171
Publisher: Elsevier Inc
Language: English
Date published: 09/2023
Academic Unit: Neurology; Emergency Medicine; Iowa Neuroscience Institute; Injury Prevention Research Center; Neurosurgery; Otolaryngology
Record Identifier: 9984442027802771

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