Delirium in the Nursing Home Patients Seen in the Emergency Department

Overview

Journal J Am Geriatr Soc

Specialty Geriatrics

Date 2009 Jun 2

PMID 19484845

Citations 27

Authors

Jin H Han

Alessandro Morandi

E Wesley Ely

Clay Callison

Chuan Zhou

Alan B Storrow

Robert S Dittus

Ralf Habermann

John Schnelle

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine whether nursing home patients are more likely than non-nursing home patients to present to the emergency department (ED) with delirium and to explore how variations in their delirium risk factor profiles contribute to this relationship.

Design: Prospective cross-sectional study.

Setting: Tertiary care academic ED.

Participants: Three hundred forty-one English-speaking patients aged 65 and older.

Measurements: Delirium status was determined using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) administered by trained research assistants. Multivariable logistic regression was used to determine whether nursing home residence was independently associated with delirium. Adjusted odds ratios (ORs) with their 95% confidence intervals (95% CIs) were reported.

Results: Of the 341 patients enrolled, 58 (17.0%) resided in a nursing home and 38 (11.1%) were considered to have delirium in the ED. Of the 58, (22 (37.9%) nursing home patients and 16 of 283 (5.7%) non-nursing home patients had delirium; unadjusted OR=10.2, 95% CI=4.9-21.2). After adjusting for dementia, a Katz activity of daily living score less than or equal to 4, hearing impairment, and the presence of systemic inflammatory response syndrome, nursing home residence was independently associated with delirium in the ED (adjusted OR=4.2, 95% CI=1.8-9.7).

Conclusion: In the ED setting, nursing home patients were more likely to present with delirium, and this relationship persisted after adjusting for delirium risk factors.

Citing Articles

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Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review.

Hobler F, McGilton K, Wittich W, Dupuis K, Reed M, Dumassais S J Alzheimers Dis. 2021; 84(3):1115-1138.

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Improving Care Transitions: An Initiative between the Emergency Department and Senior Care Facilities.

Moccia M, Keyes D Spartan Med Res J. 2021; 6(2):26862.

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Nursing Home Transfers for Behavioral Concerns: Findings from the OPTIMISTIC Demonstration Project.

Hathaway E, Carnahan J, Unroe K, Stump T, OKelly Phillips E, Hickman S J Am Geriatr Soc. 2020; 69(2):415-423.

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Delirium in Older Patients With COVID-19 Presenting to the Emergency Department.

Kennedy M, Helfand B, Gou R, Gartaganis S, Webb M, Moccia J JAMA Netw Open. 2020; 3(11):e2029540.

PMID: 33211114 PMC: 7677760. DOI: 10.1001/jamanetworkopen.2020.29540.

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