TY - JOUR T1 - Predictors and outcomes of delirium in the emergency department during the first wave of the COVID-19 pandemic in Milan JF - Emergency Medicine Journal JO - Emerg Med J SP - 202 LP - 209 DO - 10.1136/emermed-2021-211749 VL - 40 IS - 3 AU - Sarah Damanti AU - Enrica Bozzolo AU - Stefano Franchini AU - Claudia Frangi AU - Giuseppe Alvise Ramirez AU - Carla Pedroso AU - Giuseppe Di Lucca AU - Raffaella Scotti AU - Davide Valsecchi AU - Marta Cilla AU - Elena Cinel AU - Chiara Santini AU - Jacopo Castellani AU - Emanuela Manzo AU - Stefania Vadruccio AU - Marzia Spessot AU - Giovanni Borghi AU - Giacomo Monti AU - Giovanni Landoni AU - Patrizia Rovere-Querini AU - Mona-Rita Yacoub AU - Moreno Tresoldi Y1 - 2023/03/01 UR - http://emj.bmj.com/content/40/3/202.abstract N2 - Background Respiratory infections can be complicated by acute brain failure. We assessed delirium prevalence, predictors and outcomes in COVID-19 ED patients.Methods This was a retrospective observational study conducted at the San Raffaele ED (Italy). Patients age >18 years attending the ED between 26 February 2020 and 30 May 2020 and who had a positive molecular nasopharyngeal swab for SARS-CoV-2 were included. The Chart-Based Delirium Identification Instrument (CHART-DEL) was used to retrospectively assess delirium. Univariable and multivariable logistic regression analyses were used to evaluate delirium predictors. Univariable binary logistic regression analyses, linear regression analyses and Cox regression analyses were used to assess the association between delirium and clinical outcomes. Age-adjusted and sex-adjusted models were then run for the significant predictors of the univariable models.Results Among the 826 included patients, 123 cases (14.9%) of delirium were retrospectively detected through the CHART-DEL method. Patients with delirium were older (76.9±13.15 vs 61.3±14.27 years, p<0.001) and more frequently living in a long-term health facility (32 (26%) vs 22 (3.1%), p<0.001). Age (OR 1.06, 95% CI 1.04 to 1.09, p<0.001), dementia (OR 17.5, 95% CI 7.27 to 42.16, p<0.001), epilepsy (OR 6.96, 95% CI 2.48 to 19.51, p<0.001) and the number of chronic medications (OR 1.09, 95% CI 1.01 to 1.17, p=0.03) were significant predictors of delirium in multivariable analyses. Delirium was associated with increased in-hospital mortality (adjusted HR 2.16, 95% CI 1.55 to 3.03, p<0.001) and with a reduced probability of being discharged home compared with being institutionalised (adjusted OR 0.39, 95% CI 0.25 to 0.61, p<0.001).Conclusions Chart review frequently identified ED delirium in patients with COVID-19. Age, dementia, epilepsy and polypharmacy were significant predictors of ED delirium. Delirium was associated with an increased in-hospital mortality and with a reduced probability of being discharged home after hospitalisation. The findings of this single-centre retrospective study require validation in future studies.Data are available upon reasonable request. ER -