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The evaluation of delirium post‐stroke
Author(s) -
Manus John Mc,
Pathansali Rohan,
Hassan Hardi,
Ouldred Emma,
Cooper Derek,
Stewart Robert,
Macdonald Alastair,
Jackson Stephen
Publication year - 2009
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2254
Subject(s) - delirium , stroke (engine) , medicine , rating scale , confusion , acute stroke , physical therapy , psychology , psychiatry , mechanical engineering , developmental psychology , tissue plasminogen activator , engineering , psychoanalysis
Abstract Objective The aim of this study was to assess and compare the Confusion Assessment Method (CAM) and the Delirium Rating Scale (DRS) in the detection of delirium in the acute stroke setting, when used by a non‐psychiatrist doctor. Methods Consecutive participants within 4 days of an acute stroke were screened for delirium using the CAM and the DRS. Patients also had a Mini‐Mental State Examination at each assessment. Patients were screened weekly for a maximum of 4 weeks. The CAM and DRS were compared against each other with respect to agreement and applicability. Results Of 110 eligible patients, 82 were recruited over a 7 month period. Delirium developed in 23 patients (28%), 21 of whom developed delirium during week 1. We found high agreement between the CAM and the DRS in the detection of stroke in the acute stroke setting ( κ values 0.97, 0.86, 0.79 and 1 at weeks 1, 2, 3 and 4, respectively). In addition, there was strong correlation between low MMSE scores (MMSE less that 10) and delirium ( κ scores 1.0, 0.82, 0.83 and 1.0 at weeks 1, 2, 3 and 4, respectively). Conclusions Delirium is a common complication post‐stroke. The CAM is equivalent to the DRS in the acute stroke setting when used by a trained non‐psychiatrist. A low MMSE score may have a small benefit in identifying patients that are at risk of having delirium. Copyright © 2009 John Wiley & Sons, Ltd.