Diagnosing delirium in older emergency department patients: Validity and reliability of the delirium triage screen and the brief confusion assessment method

Annals of Emergency Medicine

Volumn 62, Issue 5, 2013, Pages 457-465

  Han, Jin H ^a   Wilson, Amanda ^a   Vasilevskis, Eduard E ^a,b   Shintani, Ayumi ^a   Schnelle, John F ^a,b   Dittus, Robert S ^a,b   Graves, Amy J ^a   Storrow, Alan B ^a   Shuster, John ^a   Ely, E Wesley ^a,b  

^a VANDERBILT UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; ATTENTION; BRIEF CONFUSION ASSESSMENT METHOD; CLINICAL ARTICLE; CONSCIOUSNESS; CONTROLLED STUDY; DELIRIUM; DELIRIUM TRIAGE SCREEN; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST; DIAGNOSTIC TEST ACCURACY STUDY; DSM-IV-TR; EMERGENCY HEALTH SERVICE; EMERGENCY PHYSICIAN; EMERGENCY WARD; FALSE NEGATIVE RESULT; FEMALE; GERIATRIC PATIENT; HUMAN; INTERRATER RELIABILITY; MALE; OBSERVATIONAL STUDY; PRIORITY JOURNAL; PROSPECTIVE STUDY; PSYCHIATRIST; REFERENCE DATABASE; RICHMOND AGITATION SEDATION SCALE; SCIENTIST; SCREENING TEST; SENSITIVITY AND SPECIFICITY; UNIVERSITY HOSPITAL; VALIDITY;

AGED; CONFUSION; DELIRIUM; DIAGNOSIS, DIFFERENTIAL; EMERGENCY SERVICE, HOSPITAL; FEMALE; HUMANS; MALE; REPRODUCIBILITY OF RESULTS; TRIAGE;

EID: 84886953392     PISSN: 01960644     EISSN: 10976760     Source Type: Journal    
DOI: 10.1016/j.annemergmed.2013.05.003     Document Type: Article

References (46)

1. D.G. Blazer, A.O. van Nieuwenhuizen Evidence for the diagnostic criteria of delirium: an update Curr Opin Psychiatry 25 2012 239 243
2. F.M. Hustey, S.W. Meldon, M.D. Smith The effect of mental status screening on the care of elderly emergency department patients Ann Emerg Med 41 2003 678 684
3. R. Niska, F. Bhuiya, J. Xu National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary Natl Health Stat Rep 26 2010 1 31
4. J.H. Han, A. Shintani, S. Eden Delirium in the emergency department: an independent predictor of death within 6 months Ann Emerg Med 56 2010 244 252
5. A.L. Gross, R.N. Jones, D.A. Habtemariam Delirium and long-term cognitive trajectory among persons with dementia Arch Intern Med 172 2012 1 8
6. D.H. Davis, G. Muniz Terrera, H. Keage Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study Brain 135 2012 2809 2816
7. S.K. Inouye, M.D. Foreman, L.C. Mion Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings Arch Intern Med 161 2001 2467 2473
8. M. Elie, F. Rousseau, M. Cole Prevalence and detection of delirium in elderly emergency department patients CMAJ 163 2000 977 981
9. F.M. Hustey, S.W. Meldon The prevalence and documentation of impaired mental status in elderly emergency department patients Ann Emerg Med 39 2002 248 253
10. L.M. Lewis, D.K. Miller, J.E. Morley Unrecognized delirium in ED geriatric patients Am J Emerg Med 13 1995 142 145
11. B.J. Naughton, M.B. Moran, H. Kadah Delirium and other cognitive impairment in older adults in an emergency department Ann Emerg Med 25 1995 751 755
12. R. Kakuma, G.G. du Fort, L. Arsenault Delirium in older emergency department patients discharged home: effect on survival J Am Geriatr Soc 51 2003 443 450
13. J.H. Han, E.E. Zimmerman, N. Cutler Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes Acad Emerg Med 16 2009 193 200
14. J.D. Schuur, A.K. Venkatesh The growing role of emergency departments in hospital admissions N Engl J Med 367 2012 391 393
15. A.B. Sanders Missed delirium in older emergency department patients: a quality-of-care problem Ann Emerg Med 39 2002 338 341
16. J.H. Han, S.N. Bryce, E.W. Ely The effect of cognitive impairment on the accuracy of the presenting complaint and discharge instruction comprehension in older emergency department patients Ann Emerg Med 57 2011 662 671
17. R.R. Reeves, J.D. Parker, R.S. Burke Inappropriate psychiatric admission of elderly patients with unrecognized delirium South Med J 103 2010 111 115
18. J.H. Han, S. Eden, A. Shintani Delirium in older emergency department patients is an independent predictor of hospital length of stay Acad Emerg Med 18 2011 451 457
19. C. Clarke, S.M. Friedman, K. Shi Emergency department discharge instructions comprehension and compliance study CJEM 7 2005 5 11
20. Y. Press, T. Margulin, Y. Grinshpun The diagnosis of delirium among elderly patients presenting to the emergency department of an acute hospital Arch Gerontol Geriatr 48 2009 201 204
21. C.L. Wong, J. Holroyd-Leduc, D.L. Simel Does this patient have delirium? value of bedside instruments JAMA 304 2010 779 786
22. J. Lemiengre, T. Nelis, E. Joosten Detection of delirium by bedside nurses using the Confusion Assessment Method J Am Geriatr Soc 54 2006 685 689
23. L.A. Wei, M.A. Fearing, E.J. Sternberg The Confusion Assessment Method: a systematic review of current usage J Am Geriatr Soc 56 2008 823 830
24. D. Aronsky, I. Jones, K. Lanaghan Supporting patient care in the emergency department with a computerized whiteboard system J Am Med Inform Assoc 15 2008 184 194
25. C.N. Sessler, M.S. Gosnell, M.J. Grap The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients Am J Respir Crit Care Med 166 2002 1338 1344
26. K.R. Farrell, L. Ganzini Misdiagnosing delirium as depression in medically ill elderly patients Arch Intern Med 155 1995 2459 2464
27. E.W. Ely, S.K. Inouye, G.R. Bernard Delirium in mechanically ventilated patients: validity and reliability of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) JAMA 286 2001 2703 2710
28. S.K. Inouye, C.H. van Dyck, C.A. Alessi Clarifying confusion: the Confusion Assessment Method A new method for detection of delirium Ann Intern Med 113 1990 941 948
29. E.W. Ely, B. Truman, D.J. Manzi Consciousness monitoring in ventilated patients: bispectral EEG monitors arousal not delirium Intensive Care Med 30 2004 1537 1543
30. E.W. Ely, R. Margolin, J. Francis Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) Crit Care Med 29 2001 1370 1379
31. J.L. Rudolph, R.N. Jones, L.J. Grande Impaired executive function is associated with delirium after coronary artery bypass graft surgery J Am Geriatr Soc 54 2006 937 941
32. S.K. Inouye Delirium in hospitalized older patients Clin Geriatr Med 14 1998 745 764
33. P.T. Trzepacz, D. Mittal, R. Torres Validation of the Delirium Rating Scale-revised-98: comparison with the Delirium Rating Scale and the Cognitive Test for Delirium J Neuropsychiatry Clin Neurosci 13 2001 229 242
34. E.G. Carmines, R.A. Zeller Reliability and Validity Assessment 1979 Sage Publications Beverly Hills, CA
35. American Psychiatric Association.Task Force on DSM-IV Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR 4th ed. 2000 American Psychiatric Association Washington, DC
36. S.B. Murray, D.W. Bates, L. Ngo Charlson Index is associated with one-year mortality in emergency department patients with suspected infection Acad Emerg Med 13 2006 530 536
37. M.E. Charlson, P. Pompei, K.L. Ales A new method of classifying prognostic comorbidity in longitudinal studies: development and validation J Chronic Dis 40 1987 373 383
38. W.A. Knaus, E.A. Draper, D.P. Wagner APACHE II: a severity of disease classification system Crit Care Med 13 1985 818 829
39. N. Gilboy, T. Tanabe, D. Travers Emergency Severity Index (ESI): A Triage Tool for Emergency Department Care, Version 4. Implementation Handbook 2012 Edition 2011 Agency for Healthcare Research and Quality Rockville, MD AHRQ Publication No. 12-0014
40. D.L. Simel, G.P. Samsa, D.B. Matchar Likelihood ratios with confidence: sample size estimation for diagnostic test studies J Clin Epidemiol 44 1991 763 770
41. S.K. Inouye The Confusion Assessment Method (CAM): Training Manual and Coding Guide 2003 Yale University School of Medicine New Haven, CT
42. R.S. Young, A. Arseven Diagnosing delirium JAMA 304 2010 2125 2126 author reply 2126-2127
43. F.G. Kushner, M. Hand, S.C. Smith Jr 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Circulation 120 2009 2271 2306
44. E. Rivers, B. Nguyen, S. Havstad Early goal-directed therapy in the treatment of severe sepsis and septic shock N Engl J Med 345 2001 1368 1377
45. K. Milisen, J. Lemiengre, T. Braes Multicomponent intervention strategies for managing delirium in hospitalized older people: systematic review J Adv Nurs 52 2005 79 90
46. D.A. Grimes, K.F. Schulz Refining clinical diagnosis with likelihood ratios Lancet 365 2005 1500 1505