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Updated: Sep 11, 2025

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Multidimensional Radiological Assessment of Delirium in the Emergency Department.

Alberto Francesco Cereda1, Claudia Frangi2, Matteo Rocchetti1

  • 1Cardiology Unit, ASST Santi Paolo e Carlo, 20153 Milan, Italy.

Healthcare (Basel, Switzerland)
|August 14, 2025
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Summary

Radiological markers like vascular age and cachexia can help predict mortality in older adults with delirium. This study developed a preliminary score to improve risk stratification in the emergency department.

Keywords:
brain atrophycachexiacoronary calcium scoredeliriummortality

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Area of Science:

  • Geriatric Medicine
  • Radiology
  • Neuropsychiatry

Background:

  • Delirium is a frequent, often missed, condition in older adults, linked to increased mortality and functional decline.
  • Its complex nature and association with frailty suggest radiological markers could aid risk assessment in emergency settings.

Purpose of the Study:

  • To investigate the utility of radiological markers in predicting 12-month mortality in elderly patients with delirium.
  • To develop and validate an exploratory score integrating clinical and radiological data for improved risk stratification.

Main Methods:

  • Retrospective analysis of CT scans (brain, thoracic, abdominal) from 30 elderly patients diagnosed with delirium in the emergency department.
  • Assessment of radiological markers: coronary artery calcifications (vascular age), cerebral atrophy (Global Cortical Atrophy scale), and cachexia (abdominal fat and psoas muscle volumetry).

Main Results:

  • Five factors significantly predicted 12-month mortality: vascular age, delirium etiology, cerebral atrophy, delirium subtype, and cachexia.
  • An exploratory 10-point delirium score showed acceptable accuracy for mortality prediction (sensitivity 0.93, specificity 0.73).

Conclusions:

  • A multidimensional approach combining clinical and radiological data shows promise for improving delirium risk stratification in the elderly.
  • Radiological phenotyping, especially for vascular aging and cachexia, offers objective frailty insights and may guide personalized treatment pathways.