DELIRIUM IN CRITICAL CARE UNIT PATIENTS ADMITTED THROUGH AN EMERGENCYROOM

Two hundred thirty-eight patients admitted consecutively to a critical cave unit through an emergency room were assessed prospectively for t he presence of delirium. Thirty-eight patients (16%) developed deliriu m. Delirium occurred with equal frequency in all disease categories. T he presence of abnormal head imaging which required medical interventi on did not predict the development of delirium. The median delay betwe en admission and the development of delirious was 4 days, however, one -fourth of the patients were delirious on the day Of admission. The pa tients with abnormal head imaging who required medical intervention ha d a higher frequency of onset of delirium on the first day compared wi th patients without. The delirium lasted a median of 5 days and resolv ed within a week in over 70% of patients. These results confirm that d elirium is frequently present in patients who require acute critical c are after emergency room evaluation. In this population, serious medic al disease is a better predictor of the development of delirium than t he presence of abnormal brain imaging which required medical intervent ion. Although delirious patients have longer lengths of stay, the pres ence of delirium does not predict higher mortality, as has been report ed in other populations. This could be because delirious patients admi tted to the critical care unit through the emergency room have fewer p remorbid medical problems predisposing them to poor outcome.