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lunes, 23 de enero de 2012

Delirium and the elderly in the ED

E M E R G E N C Y M E D I C I N E & C R I T I C A L C A R E R E V I E W 2 0 0 7
Delirium and the Elderly in the Emergency Department Setting
Jin H Han, John Schnelle, E. Wesly Ely
"Delirium is a form of organ dysfunction, which disproportionately affects the aging population. Among older patients presenting to the emergency department (ED), approximately 10% will have delirium. In frail, older patients, delirium is often the initial manifestation of an acute illness as opposed to fever, tachypnea, tachycardia, or hypoxia.
Delirium is also a marker for adverse outcomes and has been independently associated with increased mortality and functional and cognitive impairment. Despite its clinical importance, delirium remains undetected in 60–85% of the cases by ED physicians and is often misdiagnosed as depression or other psychiatric illnesses. This represents a major deficiency in the quality-ofcare delivered to the aging population, and recent evidence suggests that missed delirium in the ED is associated with higher mortality rates."