Comments on the article “Incidence and factors associated with delirium in an Emergency Department”

Main Article Content

José Germán Quiroz-Meléndez https://orcid.org/0000-0003-4005-3978

Keywords

Delirium, Emergency Department, Elderly

Abstract

Abstract


Delirium is underdiagnosed in the emergency department. The observed frequency was 43.8%. This figure is likely underestimated, given that detection with the Confusion Assessment Method (CAM) requires detailed, sequential clinical assessment, as well as specific training. Likewise, the fluctuating course of delirium can lead to false negatives if assessments are not repeated, which limits sensitivity and biases the estimate downward.

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References

1. Meged-Book T, Frenkel R, Nikonov A, et al. Delirium screening in the emergency department: evaluation and intervention. Isr J Health Policy Res. 2024 Apr 2;13(1):16. doi: 10.1186/s13584-024-00603-1.

2. Titlestad I, Haugarvoll K, Solvang SH, et al. Delirium is frequently underdiagnosed among older hospitalised patients despite available information in hospital medical records. Age Ageing. 2024 Feb 1;53(2):afae006. doi: 10.1093/ageing/afae006.

3. Ayón-Aguilar J, Serrano-Vértiz L, Quiroz-Lara FV, et al. Incidencia y factores asociados a delirium en un Servicio de Urgencias [Incidence and factors associated with delirium in an Emergency Department]. Rev Med Inst Mex Seguro Soc. 2025 Jan 3;63(1):e6385. Spanish. doi: 10.5281/zenodo.14200014.

4. Wu CR, Chang KM, Tranyor V, et al. Global incidence and prevalence of delirium and its risk factors in medically hospitalized older patients: A systematic review and meta-analysis. Int J Nurs Stud. 2025 Feb;162:104959. doi: 10.1016/j.ijnurstu.2024.104959.

5. LaMantia MA, Messina FC, Hobgood CD, et al. Screening for delirium in the emergency department: a systematic review. Ann Emerg Med. 2014 May;63(5):551-560.e2. doi: 10.1016/j.annemergmed.2013.11.010.

6. Han JH, Shintani A, Eden S, et al. Delirium in the emergency department: an independent predictor of death within 6 months. Ann Emerg Med. 2010 Sep;56(3):244-252.e1. doi: 10.1016/j.annemergmed.2010.03.003. Epub 2010 Apr 3.

7. Wei LA, Fearing MA, Sternberg EJ, et al. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc. 2008 May;56(5):823-30. doi: 10.1111/j.1532-5415.2008.01674.x.

8. Shenkin SD, Fox C, Godfrey M, et al. Delirium detection in older acute medical inpatients: a multicentre prospective comparative diagnostic test accuracy study of the 4AT and the confusion assessment method. BMC Med. 2019 Jul 24;17(1):138. doi: 10.1186/s12916-019-1367-9.

9. Baten V, Busch HJ, Busche C, et al. Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department. Acad Emerg Med. 2018 Nov;25(11):1251-1262. doi: 10.1111/acem.13449.