Here is a quick look at two articles published in the September issue of Annals of Emergency Medicine. Visit www.annemergmed.com to read the full text.

Delirium in the Emergency Department: An Independent Predictor of 6-Month Mortality

By JH Han, et al.

Editor’s Capsule Summary

• What is already known on this topic: The diagnosis of delirium is commonly missed among older patients who present to the emergency department.
• What question this study addressed: This 628-patient prospective cohort study examined the association between delirium and 6-month mortality.
• What this study adds to our knowledge: Mortality at 6 months was much higher among older adults with delirium (37% vs. 14%).
• How this might change clinical practice: Further research is required to determine if earlier detection and treatment of delirium alters outcome.

Stress Cardiac MRI With Observation Unit Care Reduces Costs in Patients With Emergency Chest Pain: A Randomized Trial

By CD Miller, et al.

Editor’s Capsule Summary

• What is already known on this topic: MRI offers advantages in cardiac imaging over other modalities but is a comparatively expensive option.
• What question this study addressed: Whether rule-out acute coronary syndrome patients who would ordinarily be admitted to a hospital can be managed cost-effectively in an observation unit with an MRI-based protocol.
• What this study adds to our knowledge: In this randomized trial of 110 intermediate- to high-risk acute coronary syndrome patients, an MRI-based observation unit strategy was cost effective, compared with inpatient care.
• How this is relevant to clinical practice: Facilities with cardiac MRI availability might be able to cost-effectively reduce hospital admission of intermediate- to high-risk patients with potential acute coronary syndrome.