Premium
New Cutoff Scores for Delirium Screening Tools to Predict Patient Mortality
Author(s) -
Yamanashi Takehiko,
Iwata Masaaki,
Crutchley Kaitlyn J.,
Sullivan Eleanor J.,
Malicoat Johnny R.,
Anderson ZoeElla M.,
Marra Pedro S.,
Chang Gloria,
Kaneko Koichi,
Shinozaki Eri,
Lee Sangil,
Shinozaki Gen
Publication year - 2021
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16815
Subject(s) - delirium , medicine , cutoff , intensive care unit , rating scale , mortality rate , cohort , emergency medicine , intensive care medicine , psychology , developmental psychology , physics , quantum mechanics
BACKGROUND/OBJECTIVES Detecting delirium is important to identify patients with a high risk of poor outcomes. Although many different kinds of screening instruments for delirium exist, there is no solid consensus about which methods are the most effective. In addition, it is important to find the most useful tools in predicting outcomes such as mortality. DESIGN Retrospective cohort study. SETTING University of Iowa Hospitals and Clinics. PARTICIPANTS A total of 1,125 adult inpatients (mean age = 67.7; median age = 69). MEASUREMENTS Post hoc analyses were performed based on existing data from the Confusion Assessment Method for Intensive Care Unit (CAM‐ICU), Delirium Rating Scale‐Revised‐98 (DRS), and the Delirium Observation Screening Scale (DOSS). Correlation among these scales and relationships between 365‐day mortality and each scale were evaluated. RESULTS A positive result on the CAM‐ICU (“CAM‐ICU positive”) was associated with higher DRS and DOSS scores. A DRS score = 9/10 was the best cutoff to detect CAM‐ICU positive, and DOSS = 2/3 was the best cutoff to detect CAM‐ICU positive. CAM‐ICU positive was associated with high 365‐day mortality. DRS score = 9/10 and DOSS score = 0/1 were found to differentiate mortality risk the most significantly. Higher DRS and DOSS scores significantly coincided with a decrease in a patient's survival rate at 365 days. CONCLUSION The best DRS and DOSS cutoff scores to differentiate 365‐day mortality risk were lower than those commonly used to detect delirium in the literature. New cutoff scores for the DRS and DOSS might be useful in differentiating risk of mortality among hospital patients.