The following is a summary of “Delirium, confusion, or altered mental status as a risk for abnormal head CT in older adults in the emergency department: A systematic review and meta-analysis,” published in the September 2023 issue of Emergency Medicine by Lee, et al.

Altered mental status, including delirium, is a frequently observed presentation among older adults in the emergency department (ED). For a study, researchers sought to investigate the relationship between altered mental status in older ED patients and the presence of acute abnormal findings on head computed tomography (CT).

A systematic review was conducted by searching Ovid Medline, Embase, Clinicaltrials.gov, Web of Science, and Cochrane Central from inception until April 8th, 2021. The study included citations that discussed patients aged 65 years or older who underwent head imaging during ED evaluation and reported whether these patients had delirium, confusion, or altered mental status. The process of screening, data extraction, and bias assessment was performed by two individuals. Odds ratios (OR) were estimated to assess the likelihood of abnormal neuroimaging in patients with altered mental status.

The search identified 3,031 unique citations, but only two studies involving 909 patients with delirium, confusion, or altered mental status were included. Notably, no study specifically assessed for delirium. The OR for detecting abnormal head CT findings in patients with delirium, confusion, or altered mental status was 0.35 (95% CI 0.031 to 3.97) compared to patients without these conditions.

The analysis did not find a statistically significant association between delirium, confusion, or altered mental status and abnormal findings on head CT scans in older ED patients.

Source: sciencedirect.com/science/article/abs/pii/S0735675723003273