107yield of Ct Brain Scans in Very Elderly Patients With Acute Confusion: A Retrospective Study at a District General Hospital

Lloyd, Melanie; Currie, Hannah; Paneerselvam, H; Edwards, S; Beaman, N; Jenkin, Rodric

doi:10.1093/ageing/afy203.02

Cited by 1 publication

(6 citation statements)

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“…One study included adult patients; we reported the data on the subset of patients aged 65 or above 25 . Reported abnormal CT findings were described as either “acute” or “clinically significant,” with four of the six studies explicitly defining these terms 18,24–26 . Detailed characteristics of each of the studies are presented in Tables 1 and 2.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (Choi et al 22 and Lloyd et al 24 ) examined anticoagulation as a risk factor for an abnormal head CT. The prevalence of anticoagulation in the two studies was 33/366 (0.08).…”

Section: Resultsmentioning

confidence: 99%

“…However, they could not find documentation of whether patients were on anticoagulation among 12 patients. Hence, we excluded the study from meta‐analysis of anticoagulation as a risk factor 24 …”

Section: Resultsmentioning

confidence: 99%

“…The six studies that were identified all examined CT imaging; none focused on MRI imaging. 18,[22][23][24][25][26] With the exception of one study, 18 all were retrospective cohort studies and they were conducted in a single ED. The total sample included 909 patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…25 Reported abnormal CT findings were described as either "acute" or "clinically significant," with four of the six studies explicitly defining these terms. 18,[24][25][26] Detailed characteristics of each of the studies are presented in Tables 1 and 2. The proportion of acute abnormal head CTs by study is shown in Table 3.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Head computed tomography findings in geriatric emergency department patients with delirium, altered mental status, and confusion: A systematic review

Liu

Hayes

et al. 2022

Academic Emergency Medicine

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Background: Delirium, altered mental status (AMS), or confusion among older adults are common presentations to the emergency department (ED). We aimed to report the proportion of older ED patients presenting with delirium who have acute abnormal findings on head imaging. We also assessed whether anticoagulation, neurological deficits, trauma, or headache were associated with head imaging abnormalities in these patients.Methods: A systematic review was performed using Ovid Medline, Embase, Clinicaltrials.gov, Web of Science, and Cochrane Central from conception to April 8, 2021. Citations were included if they described patients aged 65 years or older who received neuroimaging at the time of ED assessment for delirium, confusion, or AMS.Screening, data extraction, and bias assessment were performed in duplicate. The estimated proportion of patients with abnormal neuroimaging and odds ratios (ORs) for each predictor were calculated. Results:The search strategy identified 3014 unique citations, of which six studies reporting on 909 patients with confusion or AMS were included. None of the studies formally diagnosed delirium. Overall, the proportions of older ED patients with AMS or confusion were found to have an abnormal head computed tomography (CT) was 15.6% (95% confidence interval [CI] 7.3%-26.2%). The prevalence of focal neurologic findings was 13.0% (66/506) and for anticoagulation was 9.8% (33/337) among the studies who reported them. The presence of a focal neurological deficit was associated with abnormal head CT (OR 101.8, 95% CI 30.5-340.1). Anticoagulation was not associated with abnormal head CT (OR 1.2,. No studies reported on the association between headache or trauma and abnormal neuroimaging.

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Section: Resultsmentioning

confidence: 99%

“…Two studies (Choi et al 22 and Lloyd et al 24 ) examined anticoagulation as a risk factor for an abnormal head CT. The prevalence of anticoagulation in the two studies was 33/366 (0.08).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%