Observational studyBMJ open2018
Incidence of delirium in the Canadian emergency department and its consequences on hospital length of stay: a prospective observational multicentre cohort study.
Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
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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
28 citing papers in PubMed, 1 synthesis or guideline pooled 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
- The relationship between time to urgent or emergency pacemaker implantation and entry into residential aged care or death in older adults.Aging clinical and experimental research · 2026Article
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022.The western journal of emergency medicine · 2025Article
- A multicenter prospective study on the prevalence of Post Stroke Delirium and associated risk factors in Addis Ababa, Ethiopia.BMC neurology · 2025Observational
- Identifying core adverse health outcomes for frailty assessment in older adults using administrative data.Frontiers in medicine · 2025Article
- Alternate Level of Care Patients in Canada: a Scoping Review.Canadian geriatrics journal : CGJ · 2024Article
- Developing a set of emergency department performance measures to evaluate delirium care quality for older adults: a modified e-Delphi study.BMC emergency medicine · 2024Article
- Regional Anesthesia for Acute Pain Treatment in Pre-Hospital and In-Hospital Emergency Medicine.Deutsches Arzteblatt international · 2023Review
- Pharmacological Management of Agitation and Delirium in Older Adults: a Survey of Practices in Canadian Emergency Departments.Canadian geriatrics journal : CGJ · 2023Article
- Article
- Emergency Department Length of Stay Is Associated with Delirium in Older Adults.The western journal of emergency medicine · 2023Article
- Initial Development of a Patient-Reported Experience Measure for Older Adults Attending the Emergency Department: Part II-Focus Groups with Professional Caregivers.Healthcare (Basel, Switzerland) · 2023Article
- A critical appraisal of delirium clinical practice guidelines relevant to the care of older adults in the emergency department with a synthesis of recommendations: an umbrella review protocol.Systematic reviews · 2022Article
- Implementing delirium screening in the emergency department: a quality improvement project.BMJ open quality · 2022Article
- Mitigating the stress response to improve outcomes for older patients undergoing emergency surgery with the addition of beta-adrenergic blockade.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Review
- Structured Delirium Management in the Hospital.Deutsches Arzteblatt international · 2022Article
- Delirium screening with 4AT in patients aged 65 years and older admitted to the Emergency Department with suspected sepsis: a prospective cohort study.European geriatric medicine · 2022Article
- Article
- A New ICU Delirium Prevention Bundle to Reduce the Incidence of Delirium: A Randomized Parallel Group Trial.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
Corrections and comments
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe aim to determine the incidence of delirium and describe its impacts on hospital length of stay (LOS) among non-delirious community-dwelling older adults with an 8-hour exposure to the emergency department (ED) environment.
designThis is a prospective observational multicentre cohort study (March-July 2015). Patients were assessed two times per day during their entire ED stay and up to 24 hours on hospital ward.
settingThe study took place in four Canadian EDs.
participants338 included patients: (1) aged ≥65 years; (2) who had an ED stay ≥8 hours; (3) were admitted to hospital ward and (4) were independent/semi-independent. MAIN OUTCOMES AND MEASURES: The primary outcomes of this study were incident delirium in the ED or within 24 hours of ward admission and ED and hospital LOS. Functional and cognitive status were assessed using validated Older Americans Resources and Services and the modified Telephone Interview for Cognitive Status tools. The Confusion Assessment Method was used to detect incident delirium. Univariate and multivariate analyses were conducted to evaluate outcomes.
resultsMean age was 76.8 (±8.1), 17.7% were aged >85 years old and 48.8% were men. The mean incidence of delirium was 12.1% (n=41). Median IQR ED LOS was 32.4 (24.5-47.9) hours and hospital LOS was 146.6 (75.2-267.8) hours. Adjusted mean hospital LOS was increased by 105.4 hours (4.4 days) (95% CI 25.1 to 162.0, P<0.001) for patients who developed an episode of delirium compared with non-delirious patient.
conclusionsAn incident delirium was observed in one of eight independent/semi-independent older adults after an 8-hour ED exposure. An episode of delirium increases hospital LOS by 4 days and therefore has important implications for patients and could contribute to ED overcrowding through a deleterious feedback loop.
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