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<< Managing Delirium In The Emergency Department: Tools For Targeting Underlying Etiology

Disposition

Consistent with general ED care, the disposition of patients with delirium hinges on the severity of disease, the underlying etiology, medical comorbidities, and functional status, as well as factors relating to social support and appropriate follow-up. It is difficult to make broad generalizations regarding the disposition of ED patients with delirium, but emergency clinicians should recognize that delirium is an independent risk factor for increased morbidity and mortality. It should be stressed that delirious patients represent a vulnerable population with demonstrated poorer outcomes. Studies have shown that up to 37% of delirious ED patients are discharged home.11,111 Mortality for discharged delirium is increased 2 to 3 times in the 3- to 6-month period, when adjusted for comorbidity, age, and severity of illness.25 Two large ED studies with 653 elderly ED patients combined demonstrated a 31% to 37% mortality rate at 6 months post-ED-discharge compared to 14.3% for nondelirious patients.112,113

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