{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:16:53Z","timestamp":1787026613589,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the diagnostic accuracy and time impact of the 4AT scale in emergency department triage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Prospective diagnostic accuracy study was carried out. People aged \u226565\u2009years presenting to the emergency department from 1 November 2021 to 30 June 2022 were included. Nurses opportunistically screened eligible patients using the 4AT scale during triage according to the Manchester Triage System Francesc de Borja Hospital emergency department, Gand\u00eda (Spain). Accuracy was compared with medical diagnosis of delirium. Time (seconds) spent in triage with and without screening was assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 370 patients (55.1% men, mean age 81.8\u2009years), of whom 58.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009216) were screened. A final diagnosis of delirium was made in 41.4% of those screened. The most frequently used presentational flow charts and discriminators were \u2018behaving strangely\u2019 (15%) and \u2018rapid onset\u2019 (33.3%). The highest accuracy was obtained for a score of 3 points or more (sensitivity 85.1%; specificity 66.9%; positive predictive value 52.8%; negative predictive value 71.7%). No significant differences were found in the time spent in triage according to the performance of screening.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A score of 3 points or more on the 4AT scale enables rapid detection of delirium in emergency department triage, without consuming more time than conventional triage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2024.1345983","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T01:07:12Z","timestamp":1715648832000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["The 4AT scale for rapid detection of delirium in emergency department triage"],"prefix":"10.3389","volume":"11","author":[{"given":"Angela","family":"Soler-Sanchis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Miguel","family":"Mart\u00ednez-Arnau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"S\u00e1nchez-Frutos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"P\u00e9rez-Ros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1016\/j.jen.2021.01.009","article-title":"Delirium in emergency departments: is it recognized?","volume":"47","author":"El Hussein","year":"2021","journal-title":"J Emerg Nurs"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1007\/s11096-022-01378-8","article-title":"Hospitalizations of older people in an emergency department related to potential medication-induced hyperactive delirium: a cross-sectional study","volume":"44","author":"Raso","year":"2022","journal-title":"Int J Clin Pharm"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1007\/s43678-020-00004-8","article-title":"Predictors of delirium in older patients at the emergency department: a prospective multicentre derivation study","volume":"23","author":"B\u00e9land","year":"2021","journal-title":"CJEM"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.1016\/j.annemergmed.2020.09.209","article-title":"197 the use of high-risk medications in the emergency department and the prevalent delirium within the first 24 hours of hospitalization","volume":"76","author":"Lee","year":"2020","journal-title":"Ann Emerg Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1186\/s12877-020-01723-4","article-title":"A call to action for delirium research: Meta-analysis and regression of delirium associated mortality","volume":"20","author":"Aung Thein","year":"2020","journal-title":"BMC Geriatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"R257","DOI":"10.1186\/cc13084","article-title":"Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery","volume":"17","author":"Abelha","year":"2013","journal-title":"Crit Care"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1007\/s11739-017-1781-y","article-title":"Screening and detection of delirium in older ED patients: performance of the modified confusion assessment method for the emergency department (mCAM-ED). 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