• Sangil Lee, Faithe R Cavalier, Jane M Hayes, Michelle Doering, Alexander X Lo, Danya Khoujah, Matthew A Howard, de WitKerstinKDepartment of Emergency Medicine, Queens University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine,McMaster University, Hamilton, Ontario, Canada., and Shan W Liu.
• Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, United States of America. Electronic address: sangil-lee@uiowa.edu.
• Am J Emerg Med. 2023 Sep 1; 71: 190194190-194.

BackgroundAltered mental status (including delirium) is a common presentations among older adults to the emergency department (ED). We aimed to report the association between altered mental status in older ED patients and acute abnormal findings on head computed tomogram (CT).MethodsA systematic review was conducted using Ovid Medline, Embase, Clinicaltrials.gov, Web of Science, and Cochrane Central from conception to April 8th, 2021. We included citations if they described patients aged 65 years or older who received head imaging at the time of ED assessment, and reported whether patients had delirium, confusion, or altered mental status. Screening, data extraction, and bias assessment were performed in duplicate. We estimated the odds ratios (OR) for abnormal neuroimaging in patients with altered mental status.ResultsThe search strategy identified 3031 unique citations, of which two studies reporting on 909 patients with delirium, confusion or altered mental status were included. No identified study formally assessed for delirium. The OR for 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 delirium, confusion or altered mental status.ConclusionWe did not find a statistically significant association between delirium, confusion or altered mental status and abnormal head CT findings in older ED patients.Copyright © 2023 Elsevier Inc. All rights reserved.

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