Published Work by AGEM Members

 

AGEM Author Spotlight: Justine Seidenfeld, MD, MHS, Department of Emergency Medicine at Mayo Clinic - Rochester

Risk factors and risk stratification approaches for delirium screening: A Geriatric Emergency Department Guidelines 2.0 systematic review

The objective of this systematic review was to identify risk factors and/or risk stratification methods to facilitate targeted screening of older adults in the ED for prevalent delirium.  We identified 13 studies reporting risk factors or risk scores. Some of the more common factors were dementia, age over 75, and functional impairments. Risk prediction scores varied in complexity, and incorporated predisposing factors from electronic health record data, +/- precipitating risk factors obtained at the time of the ED visit. Only two studies examined the potential impact of the risk stratification tool on screening burden. No studies evaluated implementation of a risk stratification method for delirium screening or evaluated patient-oriented outcomes. While this work is part of the Geriatric ED Guidelines 2.0 efforts to update the geriatric ED guidelines, more implementation research is needed to optimize risk stratification for delirium screening in the ED and to better understand its impact on patient outcomes and operational efficiency.

Dr. Justine Seidenfeld, MD, MHS is a Physician-Investigator with the Durham VA and is a practicing emergency physician in the Department of Emergency Medicine at the Durham VA Medical Center.  Dr. Seidenfeld uses both quantitative and qualitative methods, including ethnographic approaches, to better understand patterns of care delivery for geriatric patients in the acute care setting.