Delirium in Older Emergency Department Patients Is an Independent Predictor of Hospital Length of Stay

Delirium is an underrecognized public health problem affecting 8% to 10% of older emergency department (ED) patients.1–3 This form of organ dysfunction incurs a significant economic burden, costing the United States health care system up to an estimated $152 billion per year in direct and indirect charges.4 A large proportion of these costs are likely driven by prolonged hospitalizations observed in delirious patients.5–8 However, most studies of delirium patients have been conducted in the inpatient setting, and their findings may have limited validity to the ED. Enrollment in these previous studies typically occurred within 24 to 48 hours after admission, and patients who were delirious in the hospital setting may not have been delirious in the ED. Conversely, because delirium can resolve within 24 hours in up to 51% of patients,9 patients classified as nondelirious in the hospital may have been delirious in the ED. Currently, there are limited data on the consequences of delirium in the ED, especially in regard to its association with hospital length of stay (LOS). As result, we sought to determine if delirium in the ED is associated with prolonged hospital LOS in older patients.