ArticleThe western journal of emergency medicine2021
Increased Emergency Department Hallway Length of Stay is Associated with Development of Delirium.
Article in The western journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors and risk stratification approaches for delirium screening: A Geriatric Emergency Department Guidelines 2.0 systematic review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Pooled it
- Targeted Delirium Screening in At-risk Older Adults in the Emergency Department Improves Screening Rates.Journal of the American College of Emergency Physicians open · 2026Article
- Delirium in Older Adults Presenting to the Emergency Department: Prevalence, Risk Factors, Management Strategies, and Hospital Utilization Outcomes.Journal of general internal medicine · 2026Article
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- The association between long emergency department stays and inpatient length of stay: a retrospective cohort study.BMC emergency medicine · 2026Observational
- CT Brain Utilization After Low-Risk Head Injury in Adults: A Retrospective Cohort Study and Literature Review.Cureus · 2026Article
- Fast for Real or Just a Feel? Reassessing Hallway Treatment Spaces and Their Impact on Emergency Department Operations.Journal of the American College of Emergency Physicians open · 2025Article
- Waiting room and hallway care for older adults: a qualitative study with emergency nurses and technicians.BMC geriatrics · 2025Article
- Stranded in the emergency department: an analysis of boarding trends in older adults in the United States.Health affairs scholar · 2025Article
- Article
- Experiences of the emergency department environment: a qualitative study with caregivers of people with dementia.Internal and emergency medicine · 2025Article
- Emergency Nurses' Perspectives on Adopting Geriatric Screenings for Cognitive Impairment: A Qualitative Study.Journal of emergency nursing · 2025Article
- Delirium Prevention and Management in Older Adults in the Emergency Department.Emergency medicine clinics of North America · 2025Review
- Building a public-private partnership to confront the emergency department boarding crisis.Health affairs scholar · 2025Article
- Emergency department crowding: An examination of older adults and vulnerability.Nursing ethics · 2025Article
- Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2025Article
- Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health.Seminars in neurology · 2024Review
- A scoping review of geriatric emergency medicine research transparency in diversity, equity, and inclusion reporting.Journal of the American Geriatrics Society · 2024Article
- Boarding Duration in the Emergency Department and Inpatient Delirium and Severe Agitation.JAMA network open · 2024Article
- Diversity, Equity, and Inclusion: Considerations in the Geriatric Emergency Department Patient.Clinics in geriatric medicine · 2023Review
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionOur study aimed to determine 1) the association between time spent in the emergency department (ED) hallway and the development of delirium and 2) the hospital location of delirium development.
methodsThis single-center, retrospective chart review included patients 18+ years old admitted to the hospital after presenting, without baseline cognitive impairment, to the ED in 2018. We identified the Delirium group by the following: key words describing delirium; orders for psychotropics, special observation, and restraints; or documented positive Confusion Assessment Method (CAM) screen. The Control group included patients not meeting delirium criteria. We used a multivariable logistic regression model, while adjusting for confounders, to assess the odds of delirium development associated with percentage of ED LOS spent in the hallway.
resultsA total of 25,156 patients met inclusion criteria with 1920 (7.6%) meeting delirium criteria. Delirium group vs. Control group patients spent a greater percentage of time in the ED hallway (median 50.5% vs 10.8%, P<0.001); had longer ED LOS (median 11.94 vs 8.12 hours, P<0.001); had more ED room transfers (median 5 vs 4, P<0.001); and had longer hospital LOS (median 5.0 vs 4.6 days, P<0.001). Patients more frequently developed delirium in the ED (77.5%) than on inpatient units (22.5%). The relative odds of a patient developing delirium increased by 3.31 times for each percent increase in ED hallway time (95% confidence interval, 2.85, 3.83).
conclusionPatients with delirium had more ED hallway exposure, longer ED LOS, and more ED room transfers. Understanding delirium in the ED has substantial implications for improving patient safety.
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