{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T16:39:15Z","timestamp":1766507955963,"version":"3.48.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1203","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Clinical Key Specialty Construction Program, P. R. China","award":["(2022)301-2305"],"award-info":[{"award-number":["(2022)301-2305"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate Chinese emergency physicians' perceptions of prevalence, associated risk factors, and reported management practices for delirium in critically ill emergency department (ED) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey of 402 physicians from EDs across 18 Chinese provinces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physician-estimated delirium prevalence varied widely (median: 15%; interquartile range: 10%\u201330%), with most perceiving higher incidence during night shifts. Key perceived risk factors included metabolic disorders, pre-existing cognitive impairment, shock, and severe infections. Clinical judgment was the most common assessment method; structured screening tools were reportedly used infrequently. Pharmacological interventions were the preferred management approach for most respondents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This survey highlights Chinese emergency physicians' varied perceptions of delirium prevalence and reliance on clinical judgment over standardized assessment. Findings suggest a need for enhanced training in standardized screening, greater emphasis on non-pharmacological interventions, and fostering interprofessional collaboration to improve care for ED patients with or at risk of delirium.<\/jats:p>\n                    <jats:p>Key messages What is already known on this topic: Delirium is a serious acute neurocognitive syndrome with high Intensive Care Unit prevalence (31.8%\u201370%) and significant adverse outcomes. Emergency department delirium remains under recognized despite 6%\u201338% prevalence in older adults. International guidelines recommend non-pharmacological interventions as first-line management. What this study adds: This survey provides the first assessment of Chinese emergency physicians' delirium perceptions in critically ill patients. Key findings reveal predominant reliance on clinical judgment rather than validated tools and a preference for pharmacological interventions, particularly benzodiazepines, which conflicts with international guidelines. Substantial variation exists in perceived prevalence estimates. How this study might affect research, practice, or policy: Findings inform targeted educational initiatives for Chinese emergency departments, emphasizing the need for standardized screening training and non-pharmacological intervention promotion. Future research should prioritize objective epidemiological studies to validate perceived prevalence rates and evaluate protocol implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/postmj\/qgaf136","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:36:40Z","timestamp":1754393800000},"page":"103-108","source":"Crossref","is-referenced-by-count":0,"title":["Perceived prevalence, risk factors, and reported management of delirium in critically ill emergency patients: a survey of physicians in China"],"prefix":"10.1093","volume":"102","author":[{"given":"Wen","family":"Shang","sequence":"first","affiliation":[{"name":"Department of Emergency, Peking University Third Hospital , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]},{"name":"Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Emergency, Peking University Third Hospital , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]},{"name":"Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lanfang","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Emergency, Peking University Third Hospital , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]},{"name":"Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Clinical Epidemiology Research Center of Peking University Third Hospital , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongjia","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Gansu Provincial Hospital , 204 Donggang West Road, Chengguan District, Lanzhou, Gansu 730000 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Inner Mongolia Medical University , 1 Tongdao North Road, Hohhot, Inner Mongolia 0100308 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wencao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Shanxi Provincial People\u2019s Hospital , 29 Shuangtasi Street, Yingze District, Taiyuan, Shanxi 030012 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianliang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Emergency, Affiliated Hospital of Xuzhou Medical University , No. 99 Huaihai West Road, Quanshan District, Xuzhou, Jiangsu 221132 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingbian","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Emergency, Peking University Third Hospital , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]},{"name":"Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education , 49 North Garden Road, Haidian District, Beijing 100191 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"2025122309520493400_ref1","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/s41572-020-00223-4","article-title":"Delirium","volume":"6","author":"Wilson","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"2025122309520493400_ref2","doi-asserted-by":"publisher","first-page":"2029","DOI":"10.1097\/CCM.0000000000003402","article-title":"Incidence and prevalence of delirium subtypes in an adult ICU: A systematic review and meta-analysis","volume":"46","author":"Krewulak","year":"2018","journal-title":"Crit Care Med"},{"key":"2025122309520493400_ref3","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1111\/jgs.17740","article-title":"Can we improve delirium prevention and treatment in the emergency department? A systematic review","volume":"70","author":"Lee","year":"2022","journal-title":"J Am Geriatr Soc"},{"key":"2025122309520493400_ref4","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.ajem.2022.05.058","article-title":"Delirium prevalence in geriatric emergency department patients: A systematic review and meta-analysis","volume":"59","author":"Chen","year":"2022","journal-title":"Am J Emerg Med"},{"key":"2025122309520493400_ref5","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1111\/jgs.16437","article-title":"Delirium in the emergency department: Moving from tool-based research to system-wide change","volume":"68","author":"Kennedy","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"2025122309520493400_ref6","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1093\/ageing\/afaa069","article-title":"Use of a digital delirium pathway and quality improvement to improve delirium detection in the emergency department and outcomes in an acute hospital","volume":"49","author":"Vardy","year":"2020","journal-title":"Age Ageing"},{"key":"2025122309520493400_ref7","doi-asserted-by":"publisher","first-page":"12","DOI":"10.17294\/2694-4715.1010","article-title":"A survey of delirium self-reported knowledge and practices among emergency physicians in the United States","volume":"2","author":"Chary","year":"2021","journal-title":"J Geriatr Emerg Med"},{"key":"2025122309520493400_ref8","doi-asserted-by":"publisher","first-page":"549908","DOI":"10.3389\/fneur.2020.549908","article-title":"Abnormal sleep, circadian rhythm disruption, and delirium in the ICU: Are they related?","volume":"11","author":"Daou","year":"2020","journal-title":"Front Neurol"},{"key":"2025122309520493400_ref9","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1001\/jama.2010.1013","article-title":"Delirium in elderly patients and the risk of postdischarge mortality, institutionalisation, and dementia: A meta-analysis","volume":"304","author":"Witlox","year":"2010","journal-title":"JAMA"},{"key":"2025122309520493400_ref10","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1159\/000017177","article-title":"Predisposing and precipitating factors for delirium in hospitalised older patients","volume":"10","author":"Inouye","year":"1999","journal-title":"Dement Geriatr Cogn Disord"},{"key":"2025122309520493400_ref11","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1001\/jama.2017.12067","article-title":"Delirium in older persons: Advances in diagnosis and treatment","volume":"318","author":"Oh","year":"2017","journal-title":"JAMA"},{"volume-title":"NICE Guideline CG103","year":"2018","author":"National Institute for Health and Care Excellence","key":"2025122309520493400_ref12"},{"key":"2025122309520493400_ref13","first-page":"2052","article-title":"Updated AGS beers criteria for potentially inappropriate medication use in older adults","volume":"2023","author":"American Geriatrics Society","year":"2023","journal-title":"J Am Geriatr Soc"},{"key":"2025122309520493400_ref14","doi-asserted-by":"publisher","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying confusion: The confusion assessment method. A new method for detection of delirium","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann Intern Med"},{"key":"2025122309520493400_ref15","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1136\/postgradmedj-2012-131608","article-title":"Emergency physician recognition of delirium","volume":"89","author":"Suffoletto","year":"2013","journal-title":"Postgrad Med J"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1203\/103\/64147934\/qgaf136.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/102\/1203\/103\/64147934\/qgaf136.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:52:07Z","timestamp":1766501527000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/102\/1203\/103\/8242594"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":15,"journal-issue":{"issue":"1203","published-online":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2025,12,23]]}},"URL":"https:\/\/doi.org\/10.1093\/postmj\/qgaf136","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"type":"print","value":"0032-5473"},{"type":"electronic","value":"1469-0756"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,8,28]]}}}