Frailty Assessment to Help Predict Patients at Risk of Delirium When Consulting the Emergency Department.
| Title: | Frailty Assessment to Help Predict Patients at Risk of Delirium When Consulting the Emergency Department. |
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| Authors: | Giroux M; Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada.; Sirois MJ; Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada.; Boucher V; Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada.; Daoust R; Centre de recherche de l'Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada; Université de Montréal, Montréal, Québec, Canada.; Gouin É; Centre Hospitalier Régional de Trois-Rivières, Trois-Rivières, Québec, Canada.; Pelletier M; Université Laval, Québec, Québec, Canada; Centre Intégré de Santé et de Services Sociaux de Lanaudière, Joliette, Québec, Canada.; Berthelot S; Université Laval, Québec, Québec, Canada; Centre Hospitalier de l'Université Laval (CHUL), CHU de Québec, Québec, Québec, Canada.; Voyer P; Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada.; Émond M; Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada. |
| Source: | The Journal of emergency medicine [J Emerg Med] 2018 Aug; Vol. 55 (2), pp. 157-164. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: - : New York : Elsevier; Original Publication: New York : Pergamon Press, c1983- |
| MeSH Terms: | Delirium/*complications ; Frailty/*diagnosis; Delirium/diagnosis ; Emergency Service, Hospital/organization & administration ; Frailty/etiology ; Geriatric Assessment/methods ; Physical Examination/methods ; Physical Examination/standards ; APACHE ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Prospective Studies ; Quebec ; Risk Factors |
| Abstract: | Background: Delirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium.; Objectives: To assess if screening older patients for frailty in EDs could help identify those at risk of delirium.; Methodology: This study was part of the multicenter prospective cohort INDEED study. Patients aged ≥ 65 years, initially free of delirium, with an ED stay ≥ 8 h were followed up to 24 h after ward admission. Frailty was assessed at baseline using the Clinical Frailty Scale; seniors with a score ≥ 5/7 were considered frail. Their delirium status was assessed twice daily using the Confusion Assessment Method.; Results: Among the 335 included patients, delirium occurred in 20/70 frail (28.6%) patients and in 20/265 (7.6%) robust ones. After adjusting for age and sex, the risk of delirium during ED stay was 3.13 (95% confidence interval 1.60-6.21) times higher in frail than in robust patients. Time between arrival to the ED and the incidence of delirium was also shorter for frail patients than for the robust ones (adjusted hazard ratio 2.44, 95% confidence interval 1.26-4.74).; Conclusion: Increased frailty is associated with increased delirium during ED stays. Screening for frailty at emergency triage could help ED professionals identify seniors at higher risk of delirium.; (Copyright © 2018 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: delirium; emergency department; frailty; length of stay; older adults |
| Entry Date(s): | Date Created: 20180517 Date Completed: 20190107 Latest Revision: 20190107 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.jemermed.2018.02.032 |
| PMID: | 29764723 |
| Database: | MEDLINE |
Journal Article