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Treating delirium detected in the ED

Mar. 7, 2023, 8:00 AM

by Leigh MacMillan

Delirium — a form of acute brain failure — affects 8-17% of older adults who present to the emergency department (ED). It is associated with adverse outcomes including higher health care use, accelerated functional decline, and increased mortality. 

James Jordano, Jin Han, MD, MSc, and colleagues evaluated the impact of physical and/or occupational therapy (PT/OT) on delirium duration among ED patients admitted to the hospital. The study was a secondary analysis of a prospective cohort study conducted between 2012 and 2014. Patients who were 65 or older presenting to the ED and who received PT/OT during their hospitalization were included. 

The researchers found that higher PT/OT intensity (PT/OT duration relative to hospital length of stay) was associated with shorter delirium duration. The median time to first PT/OT session was two days and was not associated with delirium duration. 

This exploratory study, published in JACEP OPEN, suggests that higher PT/OT intensity may be a useful intervention to shorten delirium duration in older hospitalized adults.

VUMC co-authors include Eduard Vasilevskis, MD, MPH, Maria Duggan, MD, MPH, Sarah Welch, DO, MPH, John Schnelle, PhD, Sandra Simmons, PhD, and E. Wesley Ely, MD, MPH. 

The research was supported by the National Institutes of Health (grants AG032355, RR024975, TR000445).

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