ArticleAge and ageing2022
Positive scores on the 4AT delirium assessment tool at hospital admission are linked to mortality, length of stay and home time: two-centre study of 82,770 emergency admissions.
Article in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed, 67 citations in OpenAlex.
- Understanding the impact of Multiple Long-Term Conditions (MLTC) on the completion of delirium screening documentation: analysis using routinely collected clinical data.European geriatric medicine · 2026Article
- Early Diagnosis of Delirium in Geriatric Patients in Emergency Departments: A Systematic Review and Meta-Analysis.Brain sciences · 2026Review
- 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
- Association of pre- and postoperative delirium with functional status at discharge after hip fracture: findings from the Gruppo Italiano di Ortogeriatria (GIOG 2.0) study.European geriatric medicine · 2026Article
- The systemic impact of acute exacerbations of COPD requiring hospitalisation: a narrative review.ERJ open research · 2026Review
- Article
- Nurses' Compliance with Delirium Assessment Protocol in a Tertiary Hospital: A Retrospective Study.Healthcare (Basel, Switzerland) · 2026Article
- Comparative risk of delirium among opioid users for non-cancer pain: a retrospective cohort study.BMC medicine · 2026Article
- Do ward changes affect outcomes differently in people living with dementia?Age and ageing · 2026Observational
- Delirium prevalence and incidence in acutely admitted older patients: an observational cohort study.BMC geriatrics · 2025Observational
- Machine learning-based predictions of healthcare contacts following emergency hospitalisation using electronic health records.NPJ digital medicine · 2025Article
- The Single Question in Delirium as a suitable tool to improve delirium detection in hospitalized older patients.European geriatric medicine · 2025Article
- Geriatricians and occupational therapists' perspectives on the role of occupational therapy in delirium care in long-term care settings: a multi-site study.European geriatric medicine · 2025Article
- Delirium is associated with incident dementia across the multimorbidity spectrum: a population-based cohort study.medRxiv : the preprint server for health sciences · 2025Article
- Delirium prevalence, diagnostic uncertainty and outcomes in ORCHARD-EPR: validation against prospective reference cohorts.Age and ageing · 2025Article
- Using scores from the 4AT delirium detection tool as an indicator of possible dementia: a study of 75 221 older adult hospital admissions.Age and ageing · 2025Article
- Neurofilament-Light Chain and Glial Fibrillary Acidic Protein as Blood-Based Delirium Risk Markers: A Multicohort Study.Aging and disease · 2025Article
- Small vessel disease contributions to acute delirium: a pilot feasibility MRI study.Age and ageing · 2025Article
- Impact of hospital readmissions following hospitalisation with delirium on 12-month mortality: a quaternary Australian hospital experience.European geriatric medicine · 2025Article
- Delirium risk and mortality in people with pre-existing severe mental illness: a retrospective cohort study using linked datasets in England.Psychological medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundStudies investigating outcomes of delirium using large-scale routine data are rare. We performed a two-centre study using the 4 'A's Test (4AT) delirium detection tool to analyse relationships between delirium and 30-day mortality, length of stay and home time (days at home in the year following admission).
methodsThe 4AT was performed as part of usual care. Data from emergency admissions in patients ≥65 years in Lothian, UK (n = 43,946) and Salford, UK (n = 38,824) over a period of $\sim$3 years were analysed using logistic regression models adjusted for age and sex.
results4AT completion rates were 77% in Lothian and 49% in Salford. 4AT scores indicating delirium (≥4/12) were present in 18% of patients in Lothian, and 25% of patients in Salford. Thirty-day mortality with 4AT ≥4 was 5.5-fold greater than the 4AT 0/12 group in Lothian (adjusted odds ratio (aOR) 5.53, 95% confidence interval [CI] 4.99-6.13) and 3.4-fold greater in Salford (aOR 3.39, 95% CI 2.98-3.87). Length of stay was more than double in patients with 4AT scores of 1-3/12 (indicating cognitive impairment) or ≥ 4/12 compared with 4AT 0/12. Median home time at 1 year was reduced by 112 days (Lothian) and 61 days (Salford) in the 4AT ≥4 group (P < 0.001).
conclusionsScores on the 4AT used at scale in practice are strongly linked with 30-day mortality, length of hospital stay and home time. The findings highlight the need for better understanding of why delirium is linked with poor outcomes and also the need to improve delirium detection and treatment.
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