Frailty Assessment to Help Predict Patients at Risk of Delirium When Consulting the Emergency Department

The Journal of Emergency Medicine
Marianne GirouxMarcel Émond

Abstract

Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium. To assess if screening older patients for frailty in EDs could help identify those at risk of delirium. This study was part of the multicenter prospective cohort INDEED study. Patients aged ≥ 65 years, initially free of delirium, with an ED stay ≥ 8 h were followed up to 24 h after ward admission. Frailty was assessed at baseline using the Clinical Frailty Scale; seniors with a score ≥ 5/7 were considered frail. Their delirium status was assessed twice daily using the Confusion Assessment Method. Among the 335 included patients, delirium occurred in 20/70 frail (28.6%) patients and in 20/265 (7.6%) robust ones. After adjusting for age and sex, the risk of delirium during ED stay was 3.13 (95% confidence interval 1.60-6.21) times higher in frail than in robust patients. Time between arrival to the ED and the incidence of delirium was also shorter for frail patients than for the robust ones (adjusted hazard ratio 2.44, 95% c...Continue Reading

Citations

Feb 2, 2019·Diseases·Pilar Pérez-Ros, Francisco Miguel Martínez-Arnau
Nov 7, 2019·Current Opinion in Critical Care·Kamil HannaBellal Joseph
Nov 3, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterUNKNOWN GEAR Network
Feb 8, 2021·Journal of the American Medical Directors Association·Xiao-Ming ZhangXin-Juan Wu
Nov 12, 2020·Clinical Interventions in Aging·Andrea Yevchak SillnerJames L Rudolph

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