Risk Factors for Delirium in Older Adults in the Emergency Department: A Systematic Review and Meta-Analysis

Author(s):  
Lucas Oliveira J. e Silva ◽  
Michelle J. Berning ◽  
Jessica A. Stanich ◽  
Danielle J. Gerberi ◽  
Mohammad Hassan Murad ◽  
...  
2019 ◽  
Vol 40 (7) ◽  
pp. 567-578 ◽  
Author(s):  
Njabulo Churchill Sibanda ◽  
Rachel Kornhaber ◽  
Glenn E. Hunt ◽  
Kirsten Morley ◽  
Michelle Cleary

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e039175
Author(s):  
Lucas Oliveira J e Silva ◽  
Michelle J Berning ◽  
Jessica A Stanich ◽  
Danielle J Gerberi ◽  
Jin Han ◽  
...  

IntroductionDelirium 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 analysisA 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 disseminationTo 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 numberCDR42020175261


2021 ◽  
Vol 144 ◽  
pp. 111184
Author(s):  
Kristin Häseler-Ouart ◽  
Habibollah Arefian ◽  
Michael Hartmann ◽  
Anja Kwetkat

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033602
Author(s):  
Deborah A Jehu ◽  
Jennifer C Davis ◽  
Teresa Liu-Ambrose

IntroductionOlder adults who fall recurrently (i.e., >1 fall/year) are at risk for functional decline and mortality. Key risk factors for recurrent falls in community-dwelling older adults are not well established due to methodological limitations, such as recall bias. A better understanding of the risk factors for recurrent falls will aid in refining clinical practice guidelines for secondary fall prevention strategies. The primary objective of this systematic review with meta-analysis is to examine the risk factors for recurrent falls in prospective studies among community-dwelling older adults.Methods and analysisA comprehensive search for articles indexed in MEDLINE, EMBASE, PsycINFO and CINAHL databases as well as grey literature was conducted on April 25, 2019. We will use MeSH and keyword search terms around the following topics: falls, recurrence, fall-risk, ageing and prospective studies. Prospective studies with monthly falls monitoring for 12 months, investigating risk factors for recurrent falls in older adults will be included. One author will complete the search. Two authors will remove duplicates and screen the titles and abstracts for their potential inclusion against the eligibility criteria. Two authors will screen the full texts and extract the data using a piloted extraction sheet. Included studies will be evaluated for the risk of bias with the Joanna Briggs Institute Prevalence Critical Appraisal tools. The quality of reporting will be determined with the Strengthening the Reporting of OBservational studies in Epidemiology. The data extraction will include study characteristics as well as sociodemographic, balance and mobility, sensory and neuromuscular, psychological, medical, medication and environmental factors. The results will be presented via figures, summary tables, meta-analysis (when possible) and narrative summaries.Ethics and disseminationNo ethics approval will be required. Findings will be disseminated through publication and media.PROSPERO registration numberCRD42019118888; Pre-results.


2015 ◽  
Vol 23 (4) ◽  
pp. 507-515 ◽  
Author(s):  
V. Silverwood ◽  
M. Blagojevic-Bucknall ◽  
C. Jinks ◽  
J.L. Jordan ◽  
J. Protheroe ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Larissa Donatoni da Silva ◽  
Agnes Shiel ◽  
Caroline McIntosh

Background: The main theme of this systematic review and meta-analysis is to synthesize the evidence of randomized controlled trial of evidence of Pilates intervention, in comparison to control groups and other forms of exercise, for falls prevention in healthy older adults.Methods: The following electronic databases were searched up to October 2020; EMBASE, Scopus, Google Scholar, MEDLINE (Ovid), Science Direct, Cochrane, and CINAHL. The recommendations of the Preferred Reporting Items of Systematic Reviews and Meta-Analyses were followed. A PICOS approach was adopted as a framework to formulate the research question and set the inclusion and exclusion criteria. Participants were healthy older adults, defined as older adults who have maintained functional ability, including participants of both genders, those with a falls history, non-fallers, and individuals who were considered to be sedentary or active. Randomized controlled trials studies, written in the English language, from the decade, were included if they focused on specific outcome measures to decrease falls risk; functional mobility, mobility, fear of falling, gait, and postural stability. The PEDro scale was used to assess risk of bias.Results: There were included 12 studies. In total, 702 healthy older adults' participants were included. Pilates showed an effect in mediolateral directions in comparison to control groups (MD = −1.77, 95% CI, −2.84 to −0.70, p = 0.001, heterogeneity: I2 = 3%), mobility (MD = 9.23, 95% CI, 5.74 to 12.73, p < 0.00001, heterogeneity: I2 = 75%) and fear of falling (MD = −8.61, 95% CI, −10.16 to −7.07, p < 0.00001, heterogeneity: I2 = 88%). In relation to other exercises group, Pilates showed positive effects in functional mobility (MD = −1.21, 95% CI, −2.30 to −0.11, p = 0.03, heterogeneity: I2 = 80%), mobility (MD = 3.25, 95% CI, 1.46 to 5.04, p < 0.0004, heterogeneity: I2 = 0%). No evidence of an improvement was found between the groups for dynamic gait index (MD = 2.26, 95% CI, −0.05 to 4.56, p = 0.06, heterogeneity: I2 = 86%), anteroposterior directions of balance (MD = −1.58, 95% CI, −3.74 to −0.59, p = 0.15, heterogeneity: I2 = 51%) and functional mobility when compared to control groups (no exercise) (MD = −1.24, 95% CI, −2.48 to −0.00, p = 0.05, heterogeneity: I2 = 87%).Discussion: Pilates may be effective in decreasing the risk of falls in older adults. Pilates intervention was found to improve functional mobility, mobility, gait, fear of falling and postural stability and therefore there is some evidence to suggest that Pilates reduces certain risk factors for falls in healthy older adults. However, there is an absence of high-quality evidence in regards to the impact of Pilates on reducing falls and further robust RCTs are needed.Systematic Review Registration: [PROSPERO], identifier [CRD42021206134].


Sign in / Sign up

Export Citation Format

Share Document