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Clear understanding of the diagnostic yield of computed tomography (CT) of the head in patients with delirium or other presentations of altered mental status (AMS) is lacking. This issue was addressed in a meta-analysis of 46 observational studies that involved 21,500 adults (mean ages across studies, >60) in whom head CTs were performed for these indications in the emergency department (ED), inpatient ward, or intensive care unit (ICU). Most studies were retrospective and lacked standardized definitions of delirium or AMS; studies of patients with falls or trauma were excluded.
Key findings were:
Among patients with delirium or AMS in the ED or inpatient ward, the diagnostic yield of head CT was 13%.
The presence of any focal neurological def…