SynthesisJournal of the American Geriatrics Society2022
Can we improve delirium prevention and treatment in the emergency department? A systematic review.
Synthesis in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 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
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- GRADE-Based Clinical Practice Guidelines for Emergency Department Delirium Risk Stratification, Screening, and Brain Imaging in Older Patients With Suspected Delirium.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Guideline
- A systematic review of interventions for persons living with dementia: The Geriatric ED Guidelines 2.0.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Pooled 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
- 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
- Can we improve delirium prevention and treatment in the emergency department? A systematic review.Journal of the American Geriatrics Society · 2022Pooled it
- Assigning Probable Dementia Status Using Routinely Collected Electronic Health Record Data.Journal of the American Geriatrics Society · 2026Article
- Article
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- Improving prehospital and emergency care for patients with mental dysregulation: a comprehensive research agenda.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Linking cortical structure and delirium in the elderly: insights from cohort study and shared genetic risk analysis.Journal of translational medicine · 2026Article
- Validation of 4 Risk Stratification Tools for Delirium in the Emergency Department.JAMA network open · 2025Article
- Outcomes of Older Adults With Delirium Discharged From the Emergency Department.Annals of emergency medicine · 2025Article
- NOTICE-ED: Nurse or Technician Insights Into Cognitive Evaluations in the Emergency Department.Journal of the American Geriatrics Society · 2025Article
- Effect of hospital-acquired complications on hospital length of stay and cost for older adults after a hip fracture in New South Wales, Australia.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Delirium Prevention and Management in Older Adults in the Emergency Department.Emergency medicine clinics of North America · 2025Review
- Implementation of delirium screening in the emergency department: A qualitative study with early adopters.Journal of the American Geriatrics Society · 2024Article
- A qualitative study of geriatric specialist nurses' experiences to navigate delirium in the elderly.BMC nursing · 2024Article
- Enhancing healthcare access for an older population: The age-friendly emergency department.Journal of the American College of Emergency Physicians open · 2024Review
- Managing Delirium in the Emergency Department: An Updated Narrative Review.Current geriatrics reports · 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
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis systematic review was conducted to evaluate any interventions to prevent incident delirium, or shorten the duration of prevalent delirium, in older adults presenting to the emergency department (ED).
methodsHealth sciences librarian designed electronic searches were conducted from database inception through September 2021. Two authors reviewed studies, and included studies that evaluated interventions for the prevention and/or treatment of delirium and excluded non-ED studies. The risk of bias (ROB) was evaluated by the Cochrane ROB tool or the Newcastle-Ottawa (NOS) scale. Meta-analysis was conducted to estimate a pooled effect of multifactorial programs on delirium prevention.
resultsOur search strategy yielded 11,900 studies of which 10 met study inclusion criteria. Two RCTs evaluated pharmacologic interventions for delirium prevention; three non-RCTs employed a multi-factorial delirium prevention program; three non-RCTs evaluated regional anesthesia for hip fractures; and one study evaluated the use of Foley catheter, medication exposure, and risk of delirium. Only four studies demonstrated a significant impact on delirium incidence or duration of delirium-one RCT of melatonin reduced the incidence of delirium (OR 0.19, 95% CI 0.06 to 0.62), one non-RCT study on a multi-factorial program decreased inpatient delirium prevalence (41% to 19%) and the other reduced incident delirium (RR 0.37, 95% CI 0.22 to 0.61). One case-control study on the use of ED Foley catheters in the ED increased the duration of delirium (proportional OR 3.1, 95% CI 1.3 to 7.4). A pooled odds ratio for three multifactorial programs on delirium prevention was 0.46 (95% CI 0.31-0.68, I
conclusionFew interventions initiated in the ED were found to consistently reduce the incidence or duration of delirium. Delirium prevention and treatment trials in the ED are still rare and should be prioritized for future research.
Indexed as
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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.