Annals of Emergency Medicine
Volume 56, Issue 3 , Pages 244-252.e1 , September 2010

Delirium in the Emergency Department: An Independent Predictor of Death Within 6 Months

Presented as an abstract at the Society for Academic Emergency Medicine national meeting, May 2009, New Orleans, LA.

  • Jin H. Han, MD, MSc

      Affiliations

    • Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
    • Corresponding Author InformationAddress for correspondence: Jin H. Han, MD, MSc, Vanderbilt University Medical Center, Department of Emergency Medicine, 703 Oxford House, Nashville, TN 37232-4700; 615-936-0253, fax 615-936-1316
    • ,
  • Ayumi Shintani, MPH, PhD

      Affiliations

    • Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
    • ,
  • Svetlana Eden, MS

      Affiliations

    • Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
    • ,
  • Alessandro Morandi, MD

      Affiliations

    • Department of Internal Medicine, Division of Allergy, Pulmonary, and Critical Care, Vanderbilt University Medical Center, Nashville, TN
    • ,
  • Laurence M. Solberg, MD

      Affiliations

    • Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, TN
    • Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, VA Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN
    • ,
  • John Schnelle, PhD

      Affiliations

    • Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, TN
    • ,
  • Robert S. Dittus, MD, MPH

      Affiliations

    • Division of General Internal Medicine, Vanderbilt University Medical Center, Nashville, TN
    • Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, VA Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN
    • ,
  • Alan B. Storrow, MD

      Affiliations

    • Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
    • ,
  • E. Wesley Ely, MD, MPH

      Affiliations

    • Department of Internal Medicine, Division of Allergy, Pulmonary, and Critical Care, Vanderbilt University Medical Center, Nashville, TN
    • Veterans Affairs Tennessee Valley Geriatric Research, Education and Clinical Center, VA Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN

Received 17 November 2009 ,Revised 2 February 2010 ,Accepted 1 March 2010.

  • Image Result

    Patients meeting inclusion and exclusion criteria.

    Patients meeting inclusion and exclusion criteria.

  • Image Result

    Kaplan-Meier survival curves in older ED patents with and without delirium. The hazard ratio of delirium on 6-month mortality is 1.72 (95% CI 1.04 to 2.86), adjusted for age, dementia, functional depe

    Kaplan-Meier survival curves in older ED patents with and without delirium. The hazard ratio of delirium on 6-month mortality is 1.72 (95% CI 1.04 to 2.86), adjusted for age, dementia, functional dependence, comorbidity burden, severity of illness, hearing impairment, and nursing home residence. This indicates that older ED patients with delirium are 72% more likely to die compared with patients without delirium.

  • Image Result
    Kaplan-Meier survival curves in older ED patents, stratified by delirium and nursing home status. In the Cox proportional hazard regression model, the “delirium*nursing home” interaction was nonsignif

    Kaplan-Meier survival curves in older ED patents, stratified by delirium and nursing home status. In the Cox proportional hazard regression model, the “delirium*nursing home” interaction was nonsignificant (P=.86); delirium in the ED's effect on 6-month mortality was similar in nursing home and non–nursing home patients.

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 Please see page 245 for the Editor's Capsule Summary of this article.

 Supervising editor: Knox H. Todd, MD, MPH

 Author contributions: JHH, JS, RSD, ABS, and EWE conceived the study and designed the trial. JHH and EWE supervised the conduct of the trial and data collection. JHH managed the data, including its quality control. JHH, AS, and SE performed the data analysis. All authors interpreted the data and contributed the contents within the discussion section. JHH, AS, AM, and LS drafted the article, and all authors contributed substantially to its revision. JHH takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. The authors have stated that no such relationships exist. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was partially supported by the Emergency Medicine Foundation. Dr. Han received support from the Vanderbilt Physicians Scientist Development grant. Dr. Ely was supported in part by the National Institutes of Health AG01023 and the Veterans Affairs Tennessee Valley Geriatric Research, Education, and Clinical Center.

 Publication date: Available online April 3, 2010.

 Reprints not available from the authors.

PII: S0196-0644(10)00220-9

doi: 10.1016/j.annemergmed.2010.03.003

Annals of Emergency Medicine
Volume 56, Issue 3 , Pages 244-252.e1 , September 2010

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