Evidence map›Paper›PMID 34625920›Full record

ArticleEuropean geriatric medicine2022

Delirium screening with 4AT in patients aged 65 years and older admitted to the Emergency Department with suspected sepsis: a prospective cohort study.

Marius Myrstad, Kanika Kuwelker, Sigurd Haakonsen, Therese Valebjørg, Nina Langeland, Bård Reiakvam Kittang, Guri Hagberg, Bjørn Erik Neerland, Marit Stordal Bakken

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Article in European geriatric medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Marius MyrstadDepartment of Internal Medicine, Bærum Hospital Vestre Viken Hospital Trust, 1346, Gjettum, Norway. marius.myrstad@vestreviken.no.ORCID 0000-0002-9682-5255
Kanika KuwelkerDepartment of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.
Sigurd HaakonsenDepartment of Internal Medicine, Bærum Hospital Vestre Viken Hospital Trust, 1346, Gjettum, Norway.
Therese ValebjørgDepartment of Internal Medicine, Bærum Hospital Vestre Viken Hospital Trust, 1346, Gjettum, Norway.
Nina LangelandDepartment of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.
Bård Reiakvam KittangDepartment of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.
Guri HagbergDepartment of Medical Research, Bærum Hospital Vestre Viken Hospital Trust, 1346, Gjettum, Norway.
Bjørn Erik NeerlandDepartment of Geriatric Medicine, Oslo University Hospital, 0424, Oslo, Norway.
Marit Stordal BakkenDepartment of Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to study the use of The 4 'A's test (4AT), a rapid delirium screening tool, performed upon Emergency Department (ED) admission, and to characterize older patients admitted to the ED with and without sepsis in terms of delirium features.

methodsIn this prospective cohort study, we included patients aged ≥ 65 years, admitted to the ED with suspected sepsis. ED nurses and doctors performed delirium screening with 4AT within two hours after ED admission, and registered the time spent on the screening in each case. Sepsis and delirium during the hospital stay were diagnosed retrospectively, according to recommended diagnosis criteria.

resultsOut of the 196 patients included (mean age 81 years, 60% men), 100 patients fulfilled the sepsis diagnosis criteria. The mean 4AT screening time was 2.5 Minutes. In total, 114 patients (58%) had a 4AT score ≥ 1, indicating cognitive impairment, upon ED admission. Sepsis patients more often had a 4AT score ≥ 4, indicating delirium, than patients without sepsis (40% vs. 26%, p < 0.05). Out of the 100 patients with sepsis, 68 (68%) had delirium during the hospital stay, as compared to 34 out of 96 patients (35%) without sepsis (p < 0.05).

conclusionDelirium screening upon ED admission, using 4AT, was feasible among patients aged ≥ 65 years admitted with suspected sepsis. Two out of three patients had at least one feature of delirium upon admission. The prevalence of delirium during the hospital stay was high, particularly in patients with sepsis. Delirium screening with 4AT in the Emergency Department.

Indexed as

DeliriumSepsisAgedAged, 80 and overEmergency Service, HospitalFemaleHumansMaleProspective StudiesRetrospective Studies4ATDeliriumEmergency departmentEncephalopathyInfectionqSOFASepsisSOFA

Identifiers

PMID34625920
PMCPMC8860779

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