ArticleThe western journal of emergency medicine2023
Emergency Department Length of Stay Is Associated with Delirium in Older Adults.
Article in The western journal of emergency medicine, 2023. 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 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
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mortality Risk Following Delirium in Older Inpatients: A Systematic Review and Meta-Analysis.Worldviews on evidence-based nursing · 2025Pooled it
- Emergency Department Boarding as a Potential Amplifier of Agitation in Delirium Superimposed on Dementia.Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society · 2026Article
- 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
- Older adults with advanced chronic illness and emergency department care: the hermeneutic stories of Bill, Edie and Nicole.BMC geriatrics · 2026Article
- Severe hypotension following sublingual dexmedetomidine administration in an elderly patient.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2026Article
- Delirium in older adults in the emergency department: a scoping review of current research and identified knowledge gaps.BMC emergency medicine · 2026Article
- Performance of the Emergency Severity Index and Patient Acuity Category Scale in geriatric triage.Singapore medical journal · 2026Observational
- Beyond Triage: Cognitive Profiles and ED-To-Inpatient Costs and Resource Pathways in Older Adults.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Orthogeriatric multidisciplinary care for hip fractures in emergency department reduces length of stay: a retrospective cohort study.BMC emergency medicine · 2025Observational
- Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022.The western journal of emergency medicine · 2025Article
- Stranded in the emergency department: an analysis of boarding trends in older adults in the United States.Health affairs scholar · 2025Article
- Is a Prolonged Emergency Department Stay a Risk for Patient Safety?Journal of the American College of Emergency Physicians open · 2025Article
- Experiences of the emergency department environment: a qualitative study with caregivers of people with dementia.Internal and emergency medicine · 2025Article
- Factors associated with hospitalization from a geriatric short-stay unit (OBI-GER): a retrospective cohort study.Aging clinical and experimental research · 2025Article
- Emergency Nurses' Perspectives on Adopting Geriatric Screenings for Cognitive Impairment: A Qualitative Study.Journal of emergency nursing · 2025Article
- Emergency Care for Persons Living with Dementia.Emergency medicine clinics of North America · 2025Review
- Building a public-private partnership to confront the emergency department boarding crisis.Health affairs scholar · 2025Article
- Factors predicting delirium among hospitalized older adults in an urban area, Thailand: A prospective cohort study.Belitung nursing journal · 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
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIncident delirium in older patients is associated with prolonged hospitalization and mortality. A recent study suggested an association between emergency department (ED) length of stay (LOS), time in ED hallways, and incident delirium. In this study we further evaluated the emerging association between incident delirium with ED LOS, time in ED hallways, and number of non-clinical patient moves in the ED.
methodsWe performed this retrospective cohort study at a single, urban, academic medical center. All data were extracted from the electronic health record. We included patients aged ≥65 years presenting to the ED and admitted to family or internal medicine services over a two-year period. Patients admitted to any other service, transferred from another hospital, discharged from the ED, or who underwent procedural sedation were excluded. The primary outcome was incident delirium, defined as a positive delirium screen, receipt of sedative medications, or use of physical restraints. Multivariable logistic regression models including age, gender, language, history of dementia, Elixhauser Comorbidity Index, number of non-clinical patient moves within the ED, total time spent in the ED hallway, and ED LOS were fitted.
resultsWe studied 5,886 patients ≥65 years of age; median age was 77 (69-83) years; 3,031 (52%) were female, and 1,361 (23%) reported a history of dementia. Overall, 1,408 (24%) patients experienced incident delirium. In multivariable models, ED LOS was associated with development of delirium (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.03, per hour), while non-clinical patient moves [OR 0.97, (95% CI 0.91-1.04) and ED hallway time [OR 0.99, 95% CI 0.98-1.01, per hour) was not associated with development of delirium.
conclusionIn this single-center study, ED length of stay was associated with incident delirium in older adults, while non-clinical patient moves and ED hallway time in the ED were not. Health systems should systemically limit time in the ED for admitted older adults.
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