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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 9, Issue.: 10


Improving Cognitive Evaluation and the Diagnosis of Delirium among Elderly Patients Visiting the Emergency Room


Boris Punchik1,2,3,  Yan Press1,2,3*, Yakov Grinshpun4,5 and  A. Mark Clarfield4,5,6,7

1Yasski Clinic, Comprehensive Geriatric Assessment Unit, Clalit Health Services, Beer-Sheva, Israel.

2Department of Family Medicine, Sial Family Medicine and Primary Care Research Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

3Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel

4Department of Geriatrics, Soroka University Medical Center, Beer-Sheva, Israel.

5Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

6Medical School for International Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

7McGill University, Montreal, Canada.

Article Information
(1) Domenico De Berardis, Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, “G. Mazzini” Hospital, Italy.
(1) Diana Tapia, National Autonomous University of Mexico, Mexico.
(2) Pietro Scicchitano, Cardiology Department, University of Bari, Italy.
(3) Anonymous, Duzce University School of Medicine, Turkey.
Complete Peer review History: http://sciencedomain.org/review-history/10203


Introduction: Delirium is a common problem among elderly patients seen in the emergency department (ED). Under-diagnosis of delirium by the ED team is common and can have serious implications.  In a previous study we found poor quality of cognitive assessment and no mention of delirium in the ED of a large teaching hospital in southern Israel in 2003.

Aim: To evaluate cognitive assessment and delirium diagnosis two years after adding of a consultant geriatrician to the ED team. 

Methods: We examined the rate of mental status assessment and the prevalence of delirium in the ED among patients older than 65 years via a retrospective chart review.

Results: In a random sample utilizing medical records of 317 older people examined in the ED during 2007-2008, cognitive assessment (full or partial) was performed for 192 of 317 (60.6%) of patients (compared with only 12.5% in 2003), and 12 cases of delirium were specifically diagnosed in the ED (3.8%) compared to none in 2003. The rate of cognitive evaluation for subsequently hospitalized patients was 45% (compared with 59% in 2003).

Conclusions: This study indicates a moderate improvement in the rate of cognitive evaluation and the diagnosis of delirium among elderly patients seen in an ED compared with a similar study which was published 5 years ago.

Keywords :

Delirium diagnosis; elderly; emergency department patients; geriatric assessment.

Full Article - PDF    Page 1-7

DOI : 10.9734/BJMMR/2015/19443

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