• Marianne Giroux, Marie-Josée Sirois, Valérie Boucher, Raoul Daoust, Émilie Gouin, Mathieu Pelletier, Simon Berthelot, Philippe Voyer, and Marcel Émond.
• Centre de Recherche du CHU de Québec, Axe Santé des populations et pratiques optimales en santé, Québec, Québec, Canada; Université Laval, Québec, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Québec, Canada.
• J Emerg Med. 2018 Aug 1; 55 (2): 157-164.

BackgroundDelirium is underdiagnosed in seniors at emergency departments (EDs) even though it is a frequent complication and is associated with functional and cognitive decline. As frailty is an independent predictor of adverse events in seniors, screening for frailty in EDs may help identify those at risk of delirium.ObjectivesTo assess if screening older patients for frailty in EDs could help identify those at risk of delirium.MethodologyThis study was part of the multicenter prospective cohort INDEED study. Patients aged ≥ 65 years, initially free of delirium, with an ED stay ≥ 8 h were followed up to 24 h after ward admission. Frailty was assessed at baseline using the Clinical Frailty Scale; seniors with a score ≥ 5/7 were considered frail. Their delirium status was assessed twice daily using the Confusion Assessment Method.ResultsAmong the 335 included patients, delirium occurred in 20/70 frail (28.6%) patients and in 20/265 (7.6%) robust ones. After adjusting for age and sex, the risk of delirium during ED stay was 3.13 (95% confidence interval 1.60-6.21) times higher in frail than in robust patients. Time between arrival to the ED and the incidence of delirium was also shorter for frail patients than for the robust ones (adjusted hazard ratio 2.44, 95% confidence interval 1.26-4.74).ConclusionIncreased frailty is associated with increased delirium during ED stays. Screening for frailty at emergency triage could help ED professionals identify seniors at higher risk of delirium.Copyright © 2018 Elsevier Inc. All rights reserved.

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