King Sarah, Uleberg Oddvar, Pedersen Sindre A, Bjørnsen Lars Petter
Trondheim Emergency Department Research Group (TEDRG), Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
Trondheim Emergency Department Research Group (TEDRG), Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
BMJ Open. 2025 May 16;15(5):e095495. doi: 10.1136/bmjopen-2024-095495.
Delirium is commonly observed in older patients who are admitted to the emergency department (ED). Previous systematic reviews have identified poor outcomes associated with delirium in surgical, intensive care and other hospital settings, yet none have specifically considered the ED. This systematic review aims to examine associations between older patients who present or develop delirium in the ED and adverse outcomes within the hospital and after discharge.
Searches will be conducted in MEDLINE, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library. There will be no date or language restrictions. Key terms will include concepts related to delirium, the ED and older adults. Observational studies or non-intervention clinical studies will be included that compare outcomes in older patients (ie, ≥65 years) with and without delirium. Outcomes of interest will include length of hospital stay, non-home discharge (eg, nursing home/residential aged care facility), cognitive impairment, decreased physical function, mortality, readmission to hospital and quality of life measures. Two reviewers will independently screen the studies. Data extraction and quality assessment will be extracted by one reviewer and checked by a second reviewer, with any disagreements resolved by discussion or by a third reviewer. Where appropriate, data will be combined in a meta-analysis and a GRADE assessment will be made for each outcome. All methods will be guided by the Cochrane Handbook and the Centre for Reviews and Dissemination and reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis statement as well as the recommendations set out by the Meta-analysis Of Observational Studies in Epidemiology group.
As this systematic review will use published data, ethical approval is not required. The results will be disseminated through a peer-reviewed publication and conference presentations.
CRD42024594975.
谵妄在入住急诊科（ED）的老年患者中很常见。以往的系统评价已确定谵妄在手术、重症监护和其他医院环境中与不良结局相关，但均未专门考虑急诊科。本系统评价旨在研究在急诊科出现或发生谵妄的老年患者与院内及出院后不良结局之间的关联。
将在MEDLINE、Embase、科学网、护理及相关健康文献累积索引和Cochrane图书馆进行检索。无日期或语言限制。关键词将包括与谵妄、急诊科和老年人相关的概念。将纳入观察性研究或非干预性临床研究，比较有和无谵妄的老年患者（即≥65岁）的结局。感兴趣的结局将包括住院时间、非回家出院（如养老院/老年护理机构）、认知障碍、身体功能下降、死亡率、再次入院和生活质量指标。两名评价员将独立筛选研究。数据提取和质量评估将由一名评价员提取并由另一名评价员检查，任何分歧将通过讨论或由第三名评价员解决。在适当情况下，数据将合并进行荟萃分析，并对每个结局进行GRADE评估。所有方法将以Cochrane手册、评价与传播中心为指导，并按照系统评价和荟萃分析的首选报告项目声明以及流行病学观察性研究荟萃分析组提出的建议进行报告。
由于本系统评价将使用已发表的数据，无需伦理批准。结果将通过同行评审出版物和会议报告进行传播。
PROSPERO注册号：CRD42024594975。
