ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2017
Exploring Delirium's Heterogeneity: Association Between Arousal Subtypes at Initial Presentation and 6-Month Mortality in Older Emergency Department Patients.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Risk factors associated with delirium in older emergency department patients: A systematic review and meta-analysis.Medicine · 2026Pooled it
- Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Association between components of the delirium syndrome and outcomes in hospitalised adults: a systematic review and meta-analysis.BMC geriatrics · 2021Pooled it
- Pooled it
- A randomized pilot and feasibility trial of live and recorded music interventions for management of delirium symptoms in acute geriatric patients.BMC geriatrics · 2025Trial
- Delirium Severity Trajectories and Outcomes in ICU Patients. Defining a Dynamic Symptom Phenotype.Annals of the American Thoracic Society · 2020Trial
- Relationship Between Intensive Care Unit Delirium Severity and 2-Year Mortality and Health Care Utilization.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2020Trial
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- A scoping review of geriatric emergency medicine research transparency in diversity, equity, and inclusion reporting.Journal of the American Geriatrics Society · 2024Article
- Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice.Current neuropharmacology · 2021Review
- Delirium Prevention, Detection, and Treatment in Emergency Medicine Settings: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- The Effects of Transcranial Direct Current Stimulation on the Cognitive and Behavioral Changes After Electrode Implantation Surgery in Rats.Frontiers in psychiatry · 2019Article
- Performance of Electronic Prediction Rules for Prevalent Delirium at Hospital Admission.JAMA network open · 2018Article
- Prognostic effects of delirium motor subtypes in hospitalized older adults: A prospective cohort study.PloS one · 2018Article
- Delirium's Arousal Subtypes and Their Relationship with 6-Month Functional Status and Cognition.PsychosomaticsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesTo determine how delirium subtyped by level of arousal at initial presentation affects 6-month mortality.
designThis was a preplanned secondary analysis of two prospective cohort studies.
settingAcademic tertiary care emergency department (ED).
participants1,084 ED patients who were 65 years old or older. MEASUREMENTS: At the time of enrollment, trained research personnel performed the Confusion Assessment Method for the Intensive Care Unit and the Richmond Agitation Sedation Score to determine delirium and level of arousal, respectively. Patients were categorized as having no delirium, delirium with normal arousal, delirium with decreased arousal, or delirium with increased arousal. Death was ascertained by medical record review and the Social Security Death Index. Cox proportional hazard regression was used to analyze the association between delirium arousal subtypes and 6-month mortality.
resultsDelirium with normal arousal was the only subtype that was significantly associated with increased 6-month mortality (hazard ratio [HR]: 3.1, 95% confidence interval [CI]: 1.3-7.4) compared with the no delirium group after adjusting for confounders. The HRs for delirium with decreased and increased arousal were 1.4 (95% CI: 0.9-2.1) and 1.3 (95% CI: 0.3-5.4), respectively.
conclusionsDelirious ED patients with normal arousal at initial presentation had a threefold increased hazard of death within 6 months compared with patients without delirium. There was a trend towards increased hazard of death in delirious ED patients with decreased arousal, but this relationship did not reach statistical significance. These data suggest that subtyping delirium by arousal may have prognostic value but requires confirmation with a larger study.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.