title: Emergency Department Stay Associated Delirium in Older Patients.
abstract: BACKGROUND
  Caring for older patients can be challenging in the Emergency Department (ED). A > 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium.
  
  
  METHODS
  A historical cohort of patients who presented to a Canadian ED in 2009 and 2011 was randomly constituted. Included patients were aged ≥ 65 years old, admitted to any hospital ward, non-delirious upon arrival and had at least a 12-hour ED stay. Delirium was detected using a modified chart-based Confusion Assessment Method (CAM) tool. Hospital length of stay (LOS) was log-transformed and linear regression assessed differences between groups. Adjustments were made for age and comorbidity profile.
  
  
  RESULTS
  200 records were reviewed, 55.5% were female, median age was 78.9 yrs (SD:7.3). 36(18%) patients experienced ED-stay associated delirium. Nearly 50% of episodes started in the ED and within 36 hours of arrival. Comorbidity profile was similar between the positive CAM group and the negative CAM group. Mean adjusted hospital LOS were 20.5 days and 11.9 days respectively (p<.03).
  
  
  CONCLUSIONS
  1 older adult out of 5 became delirious after a 12 hr ED stay. Since delirium increases hospital LOS by more than a week, better screening and implementation of preventing measures for delirium could reduce LOS and overcrowding in the ED.
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: Marcel
authors.initials: M
authors.lastname: Émond
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Grenier
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morin
authors.affiliation: Ottawa Health Research Institute, Ottawa, ON, Canada.
authors.forename: Debra
authors.initials: D
authors.lastname: Eagles
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada.
authors.forename: Valérie
authors.initials: V
authors.lastname: Boucher
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Le Sage
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: Éric
authors.initials: É
authors.lastname: Mercier
authors.affiliation: Centre d'Excellence sur le Vieillissement de Québec, Québec, QC, Canada; CHU de Québec-Hôpital de l'Enfant-Jésus, Québec, QC, Canada; Département de médecine familiale et de médecine d'urgence, Université Laval, Québec, QC, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Voyer
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Jacques S
authors.initials: JS
authors.lastname: Lee
keywords: delirium; elders; emergency department; incidence