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- Title
Valutazione del delirium nell'anziano in pronto soccorso: una revisione narrativa della letteratura.
- Authors
ISEMANN, CHRISTIAN RAMACCIANI; ROSATI, MORIS; MARZOCCHI, KATIA; RIGHI, LORENZO
- Abstract
Background: Delirium is not an uncommon problem in the emergency department (ED). In fact, according to the literature, one in ten patients experiences tills syndrome while in the ED, Routine screening tools are rarely utilized due to their complexity and the lack of training by healthcare providers. In addition, factors such as overcrowding and heavy work flows which characterize the ED, contribute to a reduce use of delirium screening tools. This work aims to review the literature in search of the latest evidence and to find the most effective tool that non specialized staff can use to early identify delirium in the elderly patients visiting the ED. Methods: A literature review was carried out on MEDLINE and CINAHL databases in the period between 13/04/2019 and 28/04/2019. The search was limited by 5-year retroactivity, full text availability, and English or Italian language. Results: Eleven studies were included in the review. Nine articles analized the Confusion Assessment Method (CAM), its modified versions mCAM-ED, bCAM and CAM-ICU, the Assessment Test for delirium and cognitive impairment (4AT), the Richmond Agitation and Sedation Scale (RASS) and its modified version mRASS. Two articles evaluated screening for clinical fragility and risk factors. Conclusions: The 4AT-scale appears to be more suitable for an early detection of delirium in the ED. In fact, it has a 2 minutes assessment, can be performed by non-psychiatrists and shows good diagnostic performances. However, further studies are needed to test its efficacy in the ED setting and be compared with other screening tools.
- Subjects
DIAGNOSIS of delirium; RISK of delirium; CINAHL database; HOSPITAL emergency services; MEDLINE; RISK assessment; SYSTEMATIC reviews; EARLY diagnosis; OLD age
- Publication
SCENARIO: Official Italian Journal of ANIARTI, 2020, Vol 37, Issue 4, p9
- ISSN
1592-5951
- Publication type
Article