{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:57:17Z","timestamp":1792112237295,"version":"4.4.0"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2023,1]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Delirium in older people is associated with significant morbidity and mortality and has life\u2010threatening etiologies making prompt recognition essential. Computed tomography of the head (CT\u2010head) may have a role in determining the cause of delirium; however, inpatient studies suggest it is overused. There is a paucity of emergency department (ED)\u2010based research surrounding the use of CT\u2010head in delirium. This study aims to describe the utility of CT\u2010head in older patients presenting to the ED with symptoms of delirium.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a retrospective chart review of patients 65\u2009years and older with symptoms of delirium who visited local EDs over a 3.5\u2010year period (2016\u20132020). We compared patients who did and did not receive CT\u2010head. Our primary objective was to determine the proportion of acute findings in patients who received CT\u2010head. Our secondary objectives were to describe the proportions of patients who did and did not receive CT\u2010head in terms of their demographics, presenting symptoms, disposition, and indications for and results of CT\u2010head scans. Chi\u2010square tests were utilized for comparisons.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 630 encounters were identified through database searching; 526 met inclusion criteria. Thirty\u2010four were excluded for presenting directly to consultants, leaving 492 included encounters. Of those who received a CT\u2010head (n<\/jats:italic>\u00a0=\u2009279), 13 (4.7%) had acute findings. Of the encounters with acute findings, four (30.77%) had focal neurological deficits (FND), and two (15.38%) had Glasgow Coma Scale (GCS) score\u2009<\u200914. Patients without CT\u2010head (n<\/jats:italic>\u00a0=\u2009213) were more likely to be discharged (p\u2009<\u20090.01) and less likely to have a FND (p\u2009<\u20090.01).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>CT\u2010head is ordered for over half of older ED patients with symptoms of delirium despite infrequent acute findings. Acute findings typically occur in the context of symptoms suggestive of intracranial abnormalities such as FND or GCS\u2009<\u200914. This suggests physicians should be more selective when ordering CT\u2010heads in patients with symptoms of delirium.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14637","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T17:28:01Z","timestamp":1670434081000},"page":"16-22","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Utility of head computed tomography for older adults with suspected delirium in the emergency department: A retrospective observational study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4703-5476","authenticated-orcid":false,"given":"Josh D.","family":"Butcher","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Royal University Hospital, University of Saskatchewan Saskatoon Saskatchewan Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-6337","authenticated-orcid":false,"given":"Mckinley C.","family":"Smith","sequence":"additional","affiliation":[{"name":"College of Medicine University of Saskatchewan Saskatoon Saskatchewan Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8649-9943","authenticated-orcid":false,"given":"Lauren","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Royal University Hospital, University of Saskatchewan Saskatoon Saskatchewan Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4531-5677","authenticated-orcid":false,"given":"Brittany","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Royal University Hospital, University of Saskatchewan Saskatoon Saskatchewan Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"issue":"8","key":"e_1_2_9_2_1","first-page":"977","article-title":"Prevalence and detection of delirium in elderly emergency department patients","volume":"163","author":"Elie M","year":"2000","journal-title":"Can Med Assoc J"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr040"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.05.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14166"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2198"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.1997.tb03690.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2008.01118.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3928\/00989134-20150723-01"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.15441\/ceem.16.163"},{"key":"e_1_2_9_11_1","unstructured":"Society for Hospital Medicine Canada Chapter.Five tests and treatments to question. Choosing Wisely Canada.2021. Accessed March 25 2021.https:\/\/choosingwiselycanada.org\/hospital\u2010medicine"},{"key":"e_1_2_9_12_1","unstructured":"National guidelines for seniors' mental health: the assessment and treatment of delirium. Canadian Coaliiton for Seniors\u2019 Mental Health. May2006. Accessed March 30 2022.https:\/\/ccsmh.ca\/wp\u2010content\/uploads\/2016\/03\/NatlGuideline_Delirium.pdf"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2006.00692.x"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14637","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.14637","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T00:11:01Z","timestamp":1692490261000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,22]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1111\/acem.14637"],"URL":"https:\/\/doi.org\/10.1111\/acem.14637","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,22]]},"assertion":[{"value":"2022-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}