{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T16:55:04Z","timestamp":1778777704895,"version":"3.51.4"},"reference-count":49,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background\/Objectives: Delirium is frequent and serious in older adults attending the emergency department (ED), but evidence on its pharmacological management in this setting is limited. This study aimed to quantify the pharmacological treatment of delirium in older adults in the ED and examine its association with subsequent hospital admission. Methods: A cross-sectional study was conducted between November 2021 and June 2022 in a Spanish ED. The sample included 153 adults aged 65 years or older with clinician-diagnosed delirium. Clinical, triage, and medication data were obtained from electronic medical records, and associations with hospital admission were analysed using multivariable logistic regression. Results: Ninety-one participants (59.5%) were hospitalised. Antipsychotic, analgesic, and benzodiazepine use was associated with hospitalisation. Absence of an underlying cause was a protective factor. The logistic regression model was significant. Conclusions: By identifying the most frequently administered pharmacological treatments for delirium in older adults in the ED and describing their association with hospitalisation, this study provides key insights into real-world clinical practice patterns in this setting.<\/jats:p>","DOI":"10.3390\/diseases14020068","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:06:16Z","timestamp":1770905176000},"page":"68","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pharmacological Management of Delirium in Older Adults in the Emergency Department: Clinical Outcomes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0099-7579","authenticated-orcid":false,"given":"Angela","family":"Soler-Sanchis","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Podiatry, Universitat de Val\u00e8ncia, 46010 Valencia, Spain"},{"name":"Emergency Department, Francesc de Borja Hospital, 46702 Gandia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1949-3290","authenticated-orcid":false,"given":"Francisco Miguel","family":"Mart\u00ednez-Arnau","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Universitat de Val\u00e8ncia, Gasc\u00f3 Oliag 5, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2118-9792","authenticated-orcid":false,"given":"Pilar","family":"P\u00e9rez-Ros","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Podiatry, Universitat de Val\u00e8ncia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","first-page":"e6385","article-title":"ncidence and factors associated with delirium in an Emergency Department","volume":"63","year":"2025","journal-title":"Rev. Med. Inst. Mex. Seguro Soc."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fan, Y.-Y., Luo, R.-Y., Wang, M.-T., Yuan, C.-Y., Sun, Y.-Y., and Jing, J.-Y. (2024). Mechanisms Underlying Delirium in Patients with Critical Illness. Front. Aging Neurosci., 16.","DOI":"10.3389\/fnagi.2024.1446523"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/j.jamda.2020.09.032","article-title":"Visual and Hearing Impairment Are Associated with Delirium in Hospitalized Patients: Results of a Multisite Prevalence Study","volume":"22","author":"Morandi","year":"2021","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13584-024-00603-1","article-title":"Delirium Screening in the Emergency Department: Evaluation and Intervention","volume":"13","author":"Frenkel","year":"2024","journal-title":"Isr. J. Health Policy Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e70004","DOI":"10.1111\/1742-6723.70004","article-title":"A Pilot Trial Exploring the Use of Music in the Emergency Department and Its Association with Delirium and Other Clinical Outcomes","volume":"37","author":"Wang","year":"2025","journal-title":"Emerg. Med. Australas."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2416343","DOI":"10.1001\/jamanetworkopen.2024.16343","article-title":"Boarding Duration in the Emergency Department and Inpatient Delirium and Severe Agitation","volume":"7","author":"Joseph","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"101486","DOI":"10.1016\/j.ienj.2024.101486","article-title":"Enhancing Triage Accuracy: The Influence of Nursing Education on Risk Prediction","volume":"75","author":"Zaboli","year":"2024","journal-title":"Int. Emerg. Nurs."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3753","DOI":"10.1111\/jgs.19188","article-title":"Implementation of Delirium Screening in the Emergency Department: A Qualitative Study with Early Adopters","volume":"72","author":"Chary","year":"2024","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e70167","DOI":"10.1111\/acem.70167","article-title":"GRADE-Based Clinical Practice Guidelines for Emergency Department Delirium Risk Stratification, Screening, and Brain Imaging in Older Patients With Suspected Delirium","volume":"33","author":"Lee","year":"2025","journal-title":"Acad. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Soler-Sanchis, A., Mart\u00ednez-Arnau, F.M., S\u00e1nchez-Frutos, J., and P\u00e9rez-Ros, P. (2024). The 4AT Scale for Rapid Detection of Delirium in Emergency Department Triage. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1345983"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"(2015). The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults. J. Am. Geriatr. Soc., 63, 142\u2013150.","DOI":"10.1111\/jgs.13281"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1213\/ANE.0000000000004641","article-title":"American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention","volume":"130","author":"Hughes","year":"2020","journal-title":"Anesth. Analg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/EJA.0000000000001876","article-title":"Update of the European Society of Anaesthesiology and Intensive Care Medicine Evidence-Based and Consensus-Based Guideline on Postoperative Delirium in Adult Patients","volume":"41","author":"Aldecoa","year":"2024","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"111113","DOI":"10.1016\/j.jclinane.2023.111113","article-title":"The Association between Midazolam Premedication and Postoperative Delirium\u2014A Retrospective Cohort Study","volume":"92","author":"Zarour","year":"2024","journal-title":"J. Clin. Anesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/acem.14166","article-title":"Delirium Prevention, Detection, and Treatment in Emergency Medicine Settings: A Geriatric Emergency Care Applied Research (GEAR) Network Scoping Review and Consensus Statement","volume":"28","author":"Carpenter","year":"2021","journal-title":"Acad. Emerg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e250814","DOI":"10.1001\/jamanetworkopen.2025.0814","article-title":"Emergency Department Programs to Support Medication Safety in Older Adults: A Systematic Review and Meta-Analysis","volume":"8","author":"Skains","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3007","DOI":"10.3390\/nursrep14040219","article-title":"The Management and Prevention of Delirium in Elderly Patients Hospitalised in Intensive Care Units: A Systematic Review","volume":"14","year":"2024","journal-title":"Nurs. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s13670-024-00413-y","article-title":"Managing Delirium in the Emergency Department: An Updated Narrative Review","volume":"13","author":"Ehrlich","year":"2024","journal-title":"Curr. Geriatr. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"European Delirium Association, and American Delirium Society (2014). The DSM-5 Criteria, Level of Arousal and Delirium Diagnosis: Inclusiveness is Safer. BMC Med., 12.","DOI":"10.1186\/s12916-014-0141-2"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Al Huraizi, A.R., Al-Maqbali, J.S., Al Farsi, R.S., Al Zeedy, K., Al-Saadi, T., Al-Hamadani, N., and Al Alawi, A.M. (2023). Delirium and Its Association with Short- and Long-Term Health Outcomes in Medically Admitted Patients: A Prospective Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12165346"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e20210054","DOI":"10.1590\/0034-7167-2021-0054","article-title":"Delirium in the elderly admitted to an emergency hospital service","volume":"75","author":"Billig","year":"2022","journal-title":"Rev. Bras. Enferm."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"112129","DOI":"10.1016\/j.exger.2023.112129","article-title":"Clinical Risk Group as a Predictor of Mortality in Delirious Older Adults in the Emergency Department","volume":"174","year":"2023","journal-title":"Exp. Gerontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e70024","DOI":"10.1002\/nop2.70024","article-title":"The Effectiveness of a Modified Manchester Triage System for Geriatric Patients: A Retrospective Quantitative Study","volume":"11","author":"Li","year":"2024","journal-title":"Nurs. Open"},{"key":"ref_24","first-page":"2642","article-title":"Identification through the Manchester Triage System of the Older Population at Risk of Delirium: A Case-Control Study","volume":"32","year":"2022","journal-title":"J. Clin. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ageing\/afx149","article-title":"Validation of the 6-Item Cognitive Impairment Test and the 4AT Test for Combined Delirium and Dementia Screening in Older Emergency Department Attendees","volume":"47","author":"Brady","year":"2018","journal-title":"Age Ageing"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.cger.2023.05.006","article-title":"Delirium and Delirium Prevention in the Emergency Department","volume":"39","author":"Lee","year":"2023","journal-title":"Clin. Geriatr. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s40138-021-00226-9","article-title":"Succinct Approach to Delirium in the Emergency Department","volume":"9","author":"Lee","year":"2021","journal-title":"Curr. Emerg. Hosp. Med. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.mpmed.2024.08.004","article-title":"Delirium in Older Adults","volume":"52","author":"Anand","year":"2024","journal-title":"Medicine"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bonfichi, A., Ceresa, I.F., Piccioni, A., Zanza, C., Longhitano, Y., Boudi, Z., Esposito, C., and Savioli, G. (2023). A Lethal Combination of Delirium and Overcrowding in the Emergency Department. J. Clin. Med., 12.","DOI":"10.3390\/jcm12206587"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e037915","DOI":"10.1136\/bmjopen-2020-037915","article-title":"Delirium Prevention and Treatment in the Emergency Department (ED): A Systematic Review Protocol","volume":"10","author":"Dahlstrom","year":"2020","journal-title":"BMJ Open"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1001\/jamasurg.2024.4800","article-title":"Diagnosis of Respiratory Sarcopenia for Stratifying Postoperative Risk in Non-Small Cell Lung Cancer","volume":"160","author":"Sun","year":"2025","journal-title":"JAMA Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1111\/jgs.19485","article-title":"Comparative Safety of Medications for Severe Agitation: A Geriatric Emergency Department Guidelines 2.0 Systematic Review","volume":"73","author":"Casey","year":"2025","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1097\/CCM.0000000000006251","article-title":"Antipsychotics in the Treatment of Delirium in Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"52","author":"Carayannopoulos","year":"2024","journal-title":"Crit. Care Med."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Hui, D., Cheng, S.-Y., and Paiva, C.E. (2024). Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice. Cancers, 16.","DOI":"10.3390\/cancers16112045"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Huang, J., Zheng, H., Zhu, X., Zhang, K., and Ping, X. (2023). The Efficacy and Safety of Haloperidol for the Treatment of Delirium in Critically Ill Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front. Med., 10.","DOI":"10.3389\/fmed.2023.1200314"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1001\/jamapsychiatry.2018.4365","article-title":"Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium: A Network Meta-Analysis","volume":"76","author":"Wu","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e2842","DOI":"10.1002\/hup.2842","article-title":"Efficacy of Tiapride in the Treatment of Psychiatric Disorders: A Systematic Review","volume":"37","author":"Zangani","year":"2022","journal-title":"Hum. Psychopharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1177\/08850666241253541","article-title":"Impact of Continuous Infusion Ketamine Compared to Continuous Infusion Benzodiazepines on Delirium in the Intensive Care Unit","volume":"39","author":"Vollmer","year":"2024","journal-title":"J. Intensive Care Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"103603","DOI":"10.1016\/j.iccn.2023.103603","article-title":"Sleep in the Intensive and Intermediate Care Units: Exploring Related Factors of Delirium, Benzodiazepine Use and Mortality","volume":"81","author":"Bijlenga","year":"2024","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1038\/s41598-024-84554-2","article-title":"Incidence and Risk Factors of Postoperative Delirium in Elderly Surgical Patients 2023","volume":"15","author":"Fenta","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"70","DOI":"10.23736\/S0375-9393.24.18338-1","article-title":"The Impact of Remimazolam Compared to Propofol on Postoperative Delirium: A Systematic Review and Meta-Analysis","volume":"91","author":"Xue","year":"2025","journal-title":"Minerva Anestesiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"454","DOI":"10.5811\/WESTJEM.59466","article-title":"Agitation Management in the Emergency Department with Physical Restraints: Where Do These Patients End Up?","volume":"24","author":"Simon","year":"2023","journal-title":"West. J. Emerg. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1016\/j.ajem.2018.10.007","article-title":"Comparison of Phenobarbital-Adjunct versus Benzodiazepine-Only Approach for Alcohol Withdrawal Syndrome in the ED","volume":"37","author":"Sullivan","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"afae073","DOI":"10.1093\/ageing\/afae073","article-title":"Understanding the Association between Pain and Delirium in Older Hospital Inpatients: Systematic Review and Meta-Analysis","volume":"53","author":"White","year":"2024","journal-title":"Age Ageing"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s00134-025-07784-6","article-title":"The Association between Pain, Analgesia, and Delirium among Critically Ill Adults: A Systematic Review and Meta-Analysis","volume":"51","author":"Leong","year":"2025","journal-title":"Intensive Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Riccardi, A., Guarino, M., Serra, S., Spampinato, M.D., Vanni, S., Shiffer, D., Voza, A., Fabbri, A., and De Iaco, F. (2023). Study and Research Center of the Italian Society of Emergency Medicine Narrative Review: Low-Dose Ketamine for Pain Management. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093256"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ozga, D., Krupa, S., Witt, P., and M\u0119drzycka-D\u0105browska, W. (2020). Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic-Narrative Overview. Healthcare, 8.","DOI":"10.3390\/healthcare8040578"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lange, S., M\u0229drzycka-Da Browska, W., Friganovi\u0107, A., Religa, D., and Krupa, S. (2022). Family Experiences and Attitudes toward Care of ICU Patients with Delirium: A Scoping Review. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1060518"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/14740338.2024.2357242","article-title":"Risk of Drug-Induced Delirium in Older Patients- a Pharmacovigilance Study of FDA Adverse Event Reporting System Database","volume":"24","author":"Jia","year":"2025","journal-title":"Expert. Opin. Drug Saf."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/2\/68\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:41:49Z","timestamp":1770907309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/14\/2\/68"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":49,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["diseases14020068"],"URL":"https:\/\/doi.org\/10.3390\/diseases14020068","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}