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Open AccessReview

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

Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal
Emergency Department, Hospital de Braga, 4710-243 Braga, Portugal
Clinical Academic Center—Braga, 4710-243 Braga, Portugal
Author to whom correspondence should be addressed.
Academic Editor: Joaquim Cerejeira
Geriatrics 2016, 1(3), 22;
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)
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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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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