Observational studyThe American journal of emergency medicine2022
Increased short-term mortality among patients presenting with altered mental status to the emergency department: A cohort study.
Observational study in The American journal of emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Prognostic Value of the Richmond Agitation-Sedation Scale for Mortality and Admission in Older Emergency Department Patients.Medicina (Kaunas, Lithuania) · 2026Article
- Prevalence and clinical implications of altered mental status in patients with infection presenting to the emergency department.Internal and emergency medicine · 2026Article
- Translation, Cultural Adaptation, and Validation of the Greek Version of the 4 'A's Test for Delirium Screening in Elderly Patients with Hip Fracture.Clinics and practice · 2026Article
- Clinical Characteristics, Aetiologies, and Disposition Outcomes of Patients Presenting with Altered Mental Status in an Academic Emergency Department.Neurosciences (Riyadh, Saudi Arabia) · 2026Article
- Validation of a chart review method for identifying delirium in the emergency department.The American journal of emergency medicine · 2025Observational
- Identifying diagnostic errors in the emergency department using trigger-based strategies.BMJ open quality · 2025Observational
- The role of vital signs in predicting mortality risk in elderly patients visiting the emergency department.BMC emergency medicine · 2025Article
- Implementation of delirium screening in the emergency department: A qualitative study with early adopters.Journal of the American Geriatrics Society · 2024Article
- Predictive value and interrater reliability of mental status and mobility assessment in the emergency department.Clinical medicine (London, England) · 2024Article
- The problem of unconscious and unidentified patients in emergency department admissions; a 3-year retrospective study.PloS one · 2024Article
- The 4AT scale for rapid detection of delirium in emergency department triage.Frontiers in medicine · 2024Article
- A fast emergency department triage score based on mobility, mental status and oxygen saturation compared with the emergency severity index: a prospective cohort study.QJM : monthly journal of the Association of Physicians · 2023Observational
- Association of delirium with increased short-term mortality among older emergency department patients: A cohort study.The American journal of emergency medicine · 2023Observational
- Clinical profile and mortality among adult patients presenting with altered mental status to the emergency departments of a tertiary hospital in Tanzania: a descriptive cohort study.The Pan African medical journal · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo evaluate the short-term mortality of adult patients presenting to the emergency department (ED) with altered mental status (AMS) as compared to other common chief complaints.
methodsObservational cohort study of adult patients (age ≥ 40) who presented to an academic ED over a 1-year period with five pre-specified complaints at ED triage: AMS, generalized weakness, chest pain, abdominal pain, and headache. Primary outcomes included 7 and 30-day mortality. Hazard ratios (HR) were calculated with 95% confidence intervals (CI) using Cox proportional hazards models adjusted for age, acuity level, and comorbidities.
resultsA total of 9850 ED visits were included for analysis from which 101 (1.0%) and 295 (3.0%) died within 7 and 30 days, respectively. Among 683 AMS visits, the 7-day mortality rate was 3.2%. Mortality was lower for all other chief complaints, including generalized weakness (17/1170, 1.5%), abdominal pain (32/3609, 0.9%), chest pain (26/3548, 0.7%), and headache (4/840, 0.5%). After adjusting for key confounders, patients presenting with AMS had a significantly higher risk of death within 7 days of ED arrival than patients presenting with chest pain (HR 3.72, 95% CI 2.05 to 6.76, p < .001). Similarly, we found that patients presenting with AMS had a significantly higher risk of dying within 30 days compared to patients with chest pain (HR 3.65, 95% CI 2.49 to 5.37, p < .001), and headache (HR 2.09, 95% CI 1.09 to 4.01, p = .026). Differences were not statistically significant for comparisons with abdominal pain and generalized weakness, but confidence intervals were wide.
conclusionPatients presenting with AMS have worse short-term prognosis than patients presenting to the ED with chest pain or headache. AMS may indicate an underlying brain dysfunction (delirium), which is associated with adverse outcomes and increased mortality.
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