{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:57:06Z","timestamp":1787068626893,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the flow charts and discriminators of the Manchester Triage System that are most likely to identify the onset of delirium in older people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delirium is an underdiagnosed geriatric syndrome, and up to 80% of all cases of delirium go undetected in emergency departments. Patient triage seeks to manage clinical risk with a view to safely and appropriately managing patient flows.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A case\u2013control study was performed according to the STROBE checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The emergency department of a secondary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Older adults aged \u226565\u00a0years and admitted from 1\u00a0January to 31 December 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Older patients were identified from the emergency department research database. Cases were defined as patients diagnosed with delirium (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0128), excluding cases of delirium due to alcohol or substance abuse. Controls were randomised from the remaining patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0128).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 29.35% of the subjects admitted to the emergency department were older adults with an incidence of delirium of 0.7%. The flow charts with the highest probability of delirium were \u2018unwell adult\u2019 [OR\u00a0=\u00a03.04 (95%CI:1.82\u20135.1)] and \u2018behaving strangely\u2019 [OR\u00a0=\u00a016.06 (95%CI:3.72\u201369.29)], and the discriminators were \u2018rapid onset\u2019 [OR\u00a0=\u00a03.3 (95%CI:1.85\u20135.88)] and \u2018new neurological deficit less than 24\u00a0h old\u2019 [OR\u00a0=\u00a04.76 (95%%CI:1.01\u201322.5). The area under the curve for \u2018unwell adult\u2019 in the presence of dementia, previous stroke and fall in the previous 30\u00a0days was 0.73 (95%CI: 0.67\u20130.79), and that for \u2018behaving strangely\u2019 in the presence of diabetes was 0.75 (95%CI: 0.69\u20130.81).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Knowing which flow charts, discriminators and risk factors are most likely to predict delirium allows the identification of the older population at risk for triage screening in emergency departments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to clinical practice<\/jats:title>\n                    <jats:p>Risk factors such as diabetes, dementia, previous stroke and recent fall among \u2018unwell adult\u2019 or \u2018behaving strangely\u2019 triaged older persons should be assessed for the probable presence of delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.16349","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:59:33Z","timestamp":1652403573000},"page":"2642-2651","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Identification through the Manchester Triage System of the older population at risk of delirium: A case\u2013control study"],"prefix":"10.1111","volume":"32","author":[{"given":"Angela","family":"Soler\u2010Sanchis","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Podiatry Universitat de Val\u00e8ncia  Valencia Spain"},{"name":"Departament de Gandia Hospital Francesc de Borja Conselleria de Sanitat Universal i Salut P\u00fablica, av. de la Medicina  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-3290","authenticated-orcid":false,"given":"Francisco Miguel","family":"Mart\u00ednez\u2010Arnau","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy Universitat de Val\u00e8ncia  Valencia Spain"},{"name":"Frailty and Cognitive Impairment Research Group (FROG) Universitat de Val\u00e8ncia  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"S\u00e1nchez\u2010Frutos","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy Universitat de Val\u00e8ncia  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"P\u00e9rez\u2010Ros","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Podiatry Universitat de Val\u00e8ncia  Valencia Spain"},{"name":"Frailty and Cognitive Impairment Research Group (FROG) Universitat de Val\u00e8ncia  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr147"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2002.121523"},{"key":"e_1_2_10_4_1","first-page":"1","article-title":"Emergency department visits among adults aged 60 and over: United States, 2014\u20132017","volume":"367","author":"Ashman J. 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