Abstract DP204: Prolonged Emergency Department Boarding and Delirium Incidence in Older Patients with Acute Ischemic Stroke

Introduction: Timeliness of acute and sub-acute stroke care are crucial for optimizing post-stroke recovery. We investigated whether emergency department (ED) boarding (i.e., holding admitted patients in the ED while awaiting an inpatient bed) was associated with incident delirium among older acute ischemic stroke (AIS) patients. Methods: Clinical data was abstracted for AIS patients (aged ≥70 years) treated in the ED at a 7-hospital stroke certified health system and subsequently admitted for an inpatient stay (Jan 2018 to Jul 2025). Patients initially held for observation or transferred to specialty units were excluded. ED boarding durations (wait times) were calculated using timestamps corresponding to when admit decisions were made and when patients ultimately departed the ED for an available bed. ED boarding was categorized as short (