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• Delirium in older adults at the ED predicts a notably high 3-month mortality rate. • Recognizing high-risk individuals and enhancing post-discharge monitoring could lower mortality. • Factors like low mean arterial pressure, low body temperature, elevated respiratory rate, prior delirium history, and malignancy presence may signal heightened 3-month mortality risk. Delirium is a common and serious neuropsychiatric syndrome characterized by acute changes in attention, cognition, and consciousness. It is frequently encountered in various clinical settings, including critical care units and postoperative care, and is associated with significant morbidity and mortality. Understanding the factors contributing to delirium-related mortality is crucial for improving patient outcomes and healthcare practices. However, the factors associated with mortality in delirium have not been well-defined in the literature. This study aimed to identify factors influencing 3-month mortality in older adults with delirium presenting to the emergency department (ED). The study was conducted prospectively and delirium was screened using the brief Confusion Assesment Method (bCAM). The primary outcome was 3-month mortality. Mann-Whitney U and Chi-square tests compared groups, Spearman correlation analyzed correlations, and multivariate logistic regression identified risk factors. Among 243 patients, 29.6% experienced in-hospital mortality, and 56.4% had 3-month mortality. Factors associated with increased mortality risk included prior delirium history (3.32-fold increase, 95%CI: 1.51-7.30), active malignancy (3.49-fold increase, 95%CI: 1.61-7.56) and increased respiratory rate (1.18-fold increase, 95%CI: 1.08-1.29). An increase in mean arterial pressure (MAP) was associated with a 0.98-fold decrease in mortality risk (95%CI: 0.96-0.99), increase in body temperature was associated with a 0.48-fold decrease in mortality risk (95%CI:0.31-0.76). In delirious older adults at the ED, higher respiratory rate, lower MAP, lower body temperature, active malignancy and prior delirium history signal elevated mortality risk. [ABSTRACT FROM AUTHOR]

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Objective: The overcrowding of emergency departments, insufficient bed capacity in these units, lack of integrated radiology units and the distance of other departments and intensive care units from the emergency department make it inevitable to transport patients within the hospital for either short-term or long-term purposes. Patients can be transported at least once for diagnostic and treatment procedures to radiology units, operating rooms, or intensive care units for admission. However, even during short-term patient transport in critical situations, complications may arise. Materials and Methods: This study evaluates the data obtained prospectively by examining the transport information of 588 patients who met the study criteria in an eight-month period in the emergency department of a university hospital in 2020. The study is designed to assess survival, disability, and the safe transport process of critically ill patients transported from the emergency department to hospital imaging, interventional procedures, surgery and admission units. For statistical analysis of the data, independent sample t-test was used for normally distributed variables, Mann-Whitney U test when the normality assumption was not met and chi-square, ANOVA tests were used for the comparison of categorical variables. The significance level for all hypothesis tests was set at 0.05. Results: Of the 588 patients included in the study, 36.9% were female and 63.1% were male, with an average age of 61.9 years. The average transport time for patients transferred for examination, admission or interventional procedures was 18.5 minutes. 63.3% of the transferred patients sought medical attention during the night shift. During transport, 51.7% of patients experienced problems. Among the issues encountered during transport, 48.3% were related to the system, 27% were related to equipment and 24.7% were related to human factors. The most common problem, accounting for 23.0%, was waiting in radiology units or corridors for radiology examinations and interventional procedures. Conclusion: In critically ill patients in the emergency department, the most common transport problems occur when planned examinations take place outside the emergency department. Therefore, the necessity of these requests should be carefully evaluated to reduce complications that may occur during transfer. The physical organization of emergency departments should be designed to facilitate the transfer of critical patients as quickly as possible to prevent problems that arise due to prolonged transfer times. [ABSTRACT FROM AUTHOR]