Risk factors for delirium among older adults in the emergency department: a systematic review protocol

Introduction Delirium is commonly missed in older adults presenting to the emergency department (ED). Although current recommendations for active screening of delirium in the ED, this might not be feasible or practical. Identifying patients at high risk for prevalent and incident delirium in the ED...

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Main Authors: Lucas Oliveira J e Silva, Michelle J Berning, Jessica A Stanich, Danielle J Gerberi, Jin Han, Fernanda Bellolio
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e039175.full
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author Lucas Oliveira J e Silva
Michelle J Berning
Jessica A Stanich
Danielle J Gerberi
Jin Han
Fernanda Bellolio
author_facet Lucas Oliveira J e Silva
Michelle J Berning
Jessica A Stanich
Danielle J Gerberi
Jin Han
Fernanda Bellolio
author_sort Lucas Oliveira J e Silva
collection DOAJ
description Introduction Delirium is commonly missed in older adults presenting to the emergency department (ED). Although current recommendations for active screening of delirium in the ED, this might not be feasible or practical. Identifying patients at high risk for prevalent and incident delirium in the ED will help to improve the screening process and to build interventions. There is currently scattered synthesis of evidence on risk factors associated with delirium in the ED. To address this gap, we are conducting a systematic review to describe the risk factors (patient vulnerability factors and precipitating factors) for delirium in the ED.Methods and analysis A literature search was performed from inception to March 2020 in Ovid EBM Reviews, Ovid EMBASE, Ovid MEDLINE, Scopus and Web of Science. We will include original research studies that report a quantitative relationship between at least one risk factor and delirium in the ED setting. Two investigators will use eligibility criteria from this protocol to independently screen titles and abstracts, and select studies based on full-text review of potentially eligible studies. After arriving at a final set of included studies, two investigators will extract data using a standardised data collection form. If appropriate, data regarding each risk factor will be pooled through a random-effect meta-analysis. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to evaluate the overall quality of evidence.Ethics and dissemination To our knowledge, this will be the first systematic review evaluating risk factors for prevalent and incident delirium specifically related to the ED setting. Results of this study will aid in the identification of older adults at risk for delirium in the ED. We aim to publish the results of this systematic review in a peer-reviewed journal with good visibility for the fields of emergency medicine and geriatrics.PROSPERO registration numberCDR42020175261
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spelling doaj-art-f090b85b89c449d7a94da307de9465d52024-12-04T19:30:09ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2020-039175Risk factors for delirium among older adults in the emergency department: a systematic review protocolLucas Oliveira J e Silva0Michelle J Berning1Jessica A Stanich2Danielle J Gerberi3Jin Han4Fernanda Bellolio5Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USADepartment of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USAEmergency Medicine, Mayo Clinic, Rochester, Minnesota, USAMayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USABlack Dog Institute, UNSW Sydney, Sydney, New South Wales, AustraliaEmergency Medicine and Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota, USAIntroduction Delirium is commonly missed in older adults presenting to the emergency department (ED). Although current recommendations for active screening of delirium in the ED, this might not be feasible or practical. Identifying patients at high risk for prevalent and incident delirium in the ED will help to improve the screening process and to build interventions. There is currently scattered synthesis of evidence on risk factors associated with delirium in the ED. To address this gap, we are conducting a systematic review to describe the risk factors (patient vulnerability factors and precipitating factors) for delirium in the ED.Methods and analysis A literature search was performed from inception to March 2020 in Ovid EBM Reviews, Ovid EMBASE, Ovid MEDLINE, Scopus and Web of Science. We will include original research studies that report a quantitative relationship between at least one risk factor and delirium in the ED setting. Two investigators will use eligibility criteria from this protocol to independently screen titles and abstracts, and select studies based on full-text review of potentially eligible studies. After arriving at a final set of included studies, two investigators will extract data using a standardised data collection form. If appropriate, data regarding each risk factor will be pooled through a random-effect meta-analysis. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to evaluate the overall quality of evidence.Ethics and dissemination To our knowledge, this will be the first systematic review evaluating risk factors for prevalent and incident delirium specifically related to the ED setting. Results of this study will aid in the identification of older adults at risk for delirium in the ED. We aim to publish the results of this systematic review in a peer-reviewed journal with good visibility for the fields of emergency medicine and geriatrics.PROSPERO registration numberCDR42020175261https://bmjopen.bmj.com/content/10/7/e039175.full
spellingShingle Lucas Oliveira J e Silva
Michelle J Berning
Jessica A Stanich
Danielle J Gerberi
Jin Han
Fernanda Bellolio
Risk factors for delirium among older adults in the emergency department: a systematic review protocol
BMJ Open
title Risk factors for delirium among older adults in the emergency department: a systematic review protocol
title_full Risk factors for delirium among older adults in the emergency department: a systematic review protocol
title_fullStr Risk factors for delirium among older adults in the emergency department: a systematic review protocol
title_full_unstemmed Risk factors for delirium among older adults in the emergency department: a systematic review protocol
title_short Risk factors for delirium among older adults in the emergency department: a systematic review protocol
title_sort risk factors for delirium among older adults in the emergency department a systematic review protocol
url https://bmjopen.bmj.com/content/10/7/e039175.full
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