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Geriatrics 2016, 1(3), 22; doi:10.3390/geriatrics1030022

Delirium Diagnostic and Screening Instruments in the Emergency Department: An Up-to-Date Systematic Review

1
Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
2
ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
3
Emergency Department, Hospital de Braga, 4710-243 Braga, Portugal
4
Clinical Academic Center—Braga, 4710-243 Braga, Portugal
*
Author to whom correspondence should be addressed.
Academic Editor: Joaquim Cerejeira
Received: 20 June 2016 / Revised: 7 August 2016 / Accepted: 26 August 2016 / Published: 1 September 2016
(This article belongs to the Special Issue Medical Disorders and Cognition in the Elderly)
View Full-Text   |   Download PDF [376 KB, uploaded 1 September 2016]   |  

Abstract

Background: Emergency care systems are at the core of modern healthcare and are the “point-of-entry/admission” into the hospital for many older/elderly patients. Among these, it is estimated that 15% to 30% will have delirium on admission and that over 50% will develop it during their stay. However, appropriate delirium diagnostic and screening still remains a critical area of need. The goal of this review is to update the field, exploring target areas in screening methods for delirium in the Emergency Department (ED), and/or acute care units, in the older population. Methods: A systematic review was conducted to search screening/diagnostic methods for delirium in the ED and/or acute care units within the ED. Results: Seven different scales were identified. Of the identified instruments, the Confusion Assessment Method (CAM) for the Intense Care Unit (CAM-ICU) was the most widely used. Of note, a brief two-step approach for delirium surveillance was defined with the Delirium Triage Screen (DTS) and the Brief Confusion Assessment Method (bCAM), and the diagnostic accuracy of the Richmond Agitation-Sedation Scale (RASS) for delirium had a good sensitivity and specificity in older patients. Conclusion: The CAM-ICU appears as the potential reference standard for use in the ED, but research in a global approach of evaluation of actual and past cognitive changes is still warranted. View Full-Text
Keywords: delirium; emergency department; CAM-ICU; organic brain syndrome; RASS delirium; emergency department; CAM-ICU; organic brain syndrome; RASS
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Mariz, J.; Costa Castanho, T.; Teixeira, J.; Sousa, N.; Correia Santos, N. Delirium Diagnostic and Screening Instruments in the Emergency Department: An Up-to-Date Systematic Review. Geriatrics 2016, 1, 22.

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