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{
    "pk": 41507,
    "title": "Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> Delirium is a critical neuropsychiatric condition that surged among older adults during the coronavirus disease 2019 (COVID-19) pandemic, likely due to social isolation resulting from distancing measures. In this study we examined trends in delirium-related emergency department (ED) visits before and during the pandemic using nationwide data from South Korea, with a focus on different phases of social distancing, to inform healthcare strategies for older adults during public health crises.</p>\n<p><strong>Methods:</strong> We obtained data from the National Emergency Department Information System (2017-2022). Changes in ED visits were assessed across pre-pandemic (January 2017–January 2020), early pandemic (February 2020–March 2022), and late pandemic (April 2022–December 2022) phases using interrupted time series analysis.</p>\n<p><strong>Results:</strong> A total of 80,442 delirium-related ED visits among adults ≥ 65 years of age were recorded. The interrupted time series analysis showed a significant step increase in ED visits during the early pandemic phase (relative risk [RR] 1.290, 95% CI 1.201-1.386; 29.0% increase), followed by a decrease in the late pandemic phase (RR 0.922, 95% CI 0.868-0.981; 7.8% decrease). The most substantial increase was for individuals 65-74 year of age during the early pandemic period (RR 1.406, 95% CI 1.264-1.564) reflecting a 40.6% increase in visits to the ED. Indirect ED visits, such as institutional referrals, also notably increased (RR 1.275, 95% CI 1.184-1.373) reflecting a 27.5% increase.</p>\n<p><strong>Conclusion:</strong> Delirium-related ED visits among older adults showed a notable 7.8% decrease during the late pandemic period, with key risk groups identified, particularly adults 65-74 of age (40.6% increase) and those referred from institutions (27.5% increase) during the early pandemic period. These findings may help inform targeted interventions and public health responses in similar healthcare settings. Despite limitations including reliance on diagnostic codes, lack of subgroup analysis by COVID-19 status, potential duplicate visit counts, and limited regional granularity this study offers important insight into delirium care needs during crisis periods. Further research should further explore causal mechanisms and the specific impact of COVID-19 infection on delirium incidence.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "COVID-19"
        },
        {
            "word": "emergency department visits"
        },
        {
            "word": "Pandemic"
        },
        {
            "word": "Interrupted Time Series Analysis"
        }
    ],
    "section": "Original Research (Limit 4000 words)",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/7nk3v8w6",
    "frozenauthors": [
        {
            "first_name": "Jeongmin",
            "middle_name": "",
            "last_name": "Moon",
            "name_suffix": "",
            "institution": "Research Institute for Public Healthcare, National Medical Center, Seoul, Republic of Korea",
            "department": ""
        },
        {
            "first_name": "Seonji",
            "middle_name": "",
            "last_name": "Kim",
            "name_suffix": "",
            "institution": "Yonsei University College of Medicine, Department of Biomedical Systems  Informatics, Seoul, Republic of Korea; Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea",
            "department": ""
        },
        {
            "first_name": "Daesung",
            "middle_name": "",
            "last_name": "Lim",
            "name_suffix": "",
            "institution": "Seoul Medical Center, Department of Emergency Medicine, Seoul, Republic of Korea",
            "department": ""
        },
        {
            "first_name": "Ho Kyung",
            "middle_name": "",
            "last_name": "Sung",
            "name_suffix": "",
            "institution": "National Medical Center, National Emergency Medical Center, Seoul, Republic of Korea",
            "department": ""
        },
        {
            "first_name": "Nami",
            "middle_name": "",
            "last_name": "Lee",
            "name_suffix": "",
            "institution": "Seoul National University Hospital, Department of Public Health, Seoul, Republic of Korea; Seoul National University, College of Medicine, Department of Human Systems  Medicine, Seoul, Republic of Korea",
            "department": ""
        },
        {
            "first_name": "Kyung-Shin",
            "middle_name": "",
            "last_name": "Lee",
            "name_suffix": "",
            "institution": "Center for Public Healthcare Policy, National Medical Center, Seoul, Republic of Korea",
            "department": ""
        }
    ],
    "date_submitted": "2024-12-20T05:52:00.390000+02:00",
    "date_accepted": "2025-05-25T18:24:58.336000+03:00",
    "date_published": "2025-11-27T08:04:21.374000+02:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/41507/galley/43187/download/"
        }
    ]
}