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The Western Journal of Emergency Medicine

Hallway nights not linked to delirium or severe agitation

Among patients aged 65 and older, delirium or severe agitation occurred in 13% in hallways versus 9% in rooms, but adjustment found no association.

Paper by Sarah E. Perelman, Melissa A. Meeker, Maura Kennedy, Joshua W. Joseph, Shan W. Liu
Patients gather in a hospital hallway and beside room doorways, with brains and similar dark tangles near each group.

Our read

Populations
Studied:
Cohort study of 8,576 patients aged 65 and older, against patients in ED rooms (Multicenter)
What changed:
After adjustment, delirium or severe agitation did not differ between hallway and room patients (odds ratio 1.06)
The catch:
Delirium was not routinely screened for, so the composite could misclassify cases

Editor of record: Boris Djordjevic · AgingResearch.News

Paper
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The 8,576 patients aged 65 and older spent midnight to 8 am in an emergency department before admission to general medicine in a retrospective multisite cohort study. The study covered admissions in 2022–2023; 1,231 patients spent the full night in a hallway rather than a room.

After accounting for measured differences between patients, hallway stays were not associated with the combined outcome of new delirium, a sudden state of confusion, and severe agitation. The range of likely values included no difference. Longer emergency department stays were associated with this outcome. Hallway stays were also linked to longer hospital stays, but not to inpatient or 30-day mortality, or to emergency department revisits or readmissions within 30 days.

Why it matters

For older adults awaiting hospital admission, the findings bear on how hospitals manage prolonged emergency department stays. The authors suggested prioritizing faster transfers to inpatient units.

Caveats

The hospitals did not routinely screen for delirium. The combined outcome used diagnoses, nursing screens, certain injected medications or physical restraints, which may not identify delirium precisely; the findings concern patients aged 65 and older awaiting general medicine admission.

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