TY - JOUR
T1 - Risk factors for delirium among older adults in the emergency department
T2 - A systematic review protocol
AU - Oliveira J E Silva, Lucas
AU - Berning, Michelle J.
AU - Stanich, Jessica A.
AU - Gerberi, Danielle J.
AU - Han, Jin
AU - Bellolio, Fernanda
N1 - Funding Information:
Funding This study received funding through the Kern Society Innovation Award, from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The funders’ and authors’ institutions are not responsible for its content.
Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/7/20
Y1 - 2020/7/20
N2 - 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 number CDR42020175261
AB - 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 number CDR42020175261
KW - accident & emergency medicine
KW - delirium & cognitive disorders
KW - geriatric medicine
KW - protocols & guidelines
UR - http://www.scopus.com/inward/record.url?scp=85088351154&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85088351154&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-039175
DO - 10.1136/bmjopen-2020-039175
M3 - Review article
C2 - 32690751
AN - SCOPUS:85088351154
SN - 2044-6055
VL - 10
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e039175
ER -