Clinical utility and validation of two instruments (the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale) to detect delirium in geriatric inpatients

Leung, Jess Lam-Ming; Leung, Vienna cheuk-wing; Leung, C. M.; Pan, Pey-Chyou

doi:10.1016/j.genhosppsych.2007.12.007

Cited by 68 publications

(64 citation statements)

References 19 publications

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“…For delirium to be defined, both the first and the second criteria have to be present, plus either: the third or the fourth criteria present, or both the third and forth criteria present together (Inouye et al, 1990). The CAM in the Chinese language has been proven to have good reliability and validity with use in the Chinese elderly population (Leung et al, 2008). …”

Section: Methodsmentioning

confidence: 99%

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Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery

Shi

et al. 2014

Front. Aging Neurosci.

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Objective: Memorial Delirium Assessment Scale (MDAS) assesses severity of delirium. However, whether the MDAS can be used in a Chinese population is unknown. Moreover, the optimal postoperative MDAS cutoff point for describing postoperative delirium in Chinese remains largely to be determined. We therefore performed a pilot study to validate MDAS in the Chinese language and to determine the optimal postoperative MDAS cutoff point for delirium.Methods: Eighty-two patients (80 ± 6 years, 21.9% male), who had hip surgery under general anesthesia, were enrolled. The Confusion Assessment Method (CAM) and Mini-Mental State Examination (MMSE) were administered to the patients before surgery. The CAM and MDAS were performed on the patients on the first, second and fourth postoperative days. The reliability and validity of the MDAS were determined. A receiver operating characteristic (ROC) curve was used to determine the optimal Chinese version MDAS cutoff point for the identification of delirium.Results: The Chinese version of the MDAS had satisfactory internal consistency (α = 0.910). ROC analysis obtained an average optimal MDAS cutoff point of 7.5 in describing the CAM-defined postoperative delirium, with an area under the ROC of 0.990 (95% CI 0.977–1.000, P < 0.001).Conclusions: The Chinese version of the MDAS had good reliability and validity. The patients whose postoperative Chinese version MDAS cutoff point score was 7.5 would likely have postoperative delirium. These results have established a system for a larger scale study in the future.

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Section: Methodsmentioning

confidence: 99%

“…The Confusion Assessment Method (CAM; Inouye et al, 1990), which has been translated into Chinese (Leung et al, 2008), is widely used to determine the prevalence of delirium. The Memorial Delirium Assessment Scale (MDAS) has been used to assess the severity of delirium based on 10 features (Breitbart et al, 1997; Marcantonio et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery

Shi

et al. 2014

Front. Aging Neurosci.

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“…그러나 이 도구는 전문 적인 훈련을 받은 사람만이 적용할 수 있으므로 (Gaudreau et al, 2005;Inouye et al, 2001;Lemiengre et al, 2006;Schuurmans et al, 2001) 의사나 훈련받은 전문가에 비해 섬망 증상에 대한 지식과 사정 능 력이 부족한 간호사들이 선별에 사용하기에는 어려움이 있을 수 있다 (Leung et al, 2008;Steis & Fick, 2008). 또한 CAM을 이용하여 환 자의 섬망 여부를 선별하려면 장기간의 면담 기법이 필요하기 때문 에 중환자실이 아닌 일반 병동 간호사들이 일상적인 간호 업무에서 수행하기에는 제한점이 있을 수 있다 (Gaudreau et al;Leung et al;Mccusker et al, 2011;Schreier, 2010) • 2단계-1개 노인 병동에 1개월 동안 입원한 노인 전수 중 대상자 선정기준에 적합한 42명 전수를 대상으로 예비조사를 실시하였다. …”

Section: 섬망을 사정하거나 진단할 수 있는 도구 중 현재까지 전 세계적 으로 가장 많이 활용되고 있는 도구는 Confunclassified

“…간호사들이 섬망 에 대한 이해 부족으로 적절한 선별 도구를 적용하지 못하면 입원 노인의 중요한 정신적 건강 문제인 섬망의 조기 발견 및 효율적 간 호가 불가능하다 (Gaudreau et al, 2005;Leung, Leung, Leung, & Pan, 2008;Schreier;Steis & Fick, 2008).…”

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Development and validation of the Korean Nursing Delirium Scale

Kim

et al. 2012

J Korean Acad Nurs

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Purpose: The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital. Methods: The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n= 361) and the results of a pilot study (n= 42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC). Results: Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74. Conclusion: Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.

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“…The presence or absence of POD was defined according to the Confusion Assessment Method (CAM), and the severity of POD was defined according to the Memorial Delirium Assessment Scale (MDAS) (Inouye et al, 1990; Schuurmans et al, 2003). The Chinese version of the CAM and MDAS have been proved to have good reliability and validity with use in the Chinese elderly population (Leung et al, 2008; Shi et al, 2014). In this study, the highest CAM and MDAS scores from the postoperative day 1 and day 2 were presented.…”

Section: Methodsmentioning

confidence: 99%

NeurimmiRs and Postoperative Delirium in Elderly Patients Undergoing Total Hip/Knee Replacement: A Pilot Study

Dong

Sun

et al. 2017

Front. Aging Neurosci.

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Objective: Postoperative delirium (POD) is a frequent complication after surgery and its occurrence is associated with poor outcomes. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The purpose of this study was to investigate the associations between the preoperative expression levels of microRNA (miR)-146a, miR-125b, and miR-181c in cerebrospinal fluid (CSF) and serum and the development and severity of POD.Methods: Forty elderly patients aged 65 years old and older admitted for elective total hip/knee replacement under spinal anesthesia. Preoperatively, baseline cognitive function was assessed using the Mini-Mental State Examination. Each patient was interviewed daily on the first and second postoperative days. Delirium was diagnosed using the Confusion Assessment Method, and delirium severity was measured using the Memorial Delirium Assessment Scale (MDAS). Preoperative serum and CSF miR levels were determined by quantitative real-time PCR (qRT-PCR).Results: POD was detected in 27.5% (11/40) of patients. Up-regulation of miR-146a and miR-181c in CSF and down-regulation of miR-146a in serum were observed preoperatively in patients who developed POD, while patients with and without POD did not differ in serum or CSF levels of miR-125b. Delirious patients had higher CSF/serum ratios of miR-146a and miR-181c levels than non-delirious patients. The lower CSF miR-146a and CSF/serum miR-146a ratios were significantly associated with milder POD severity, represented by a lower MDAS score.Conclusion: The dysregulation of preoperative miR-146a and miR-181c in CSF and serum was associated with the development and severity of POD. These NeurimmiRs might participate in the neuropathogenesis of POD, pending further investigations.Clinical trial registration: this study was registered at ClinicalTrials.gov (NCT02817386).

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Clinical utility and validation of two instruments (the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale) to detect delirium in geriatric inpatients

Cited by 68 publications

References 19 publications

Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery

Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery

Development and validation of the Korean Nursing Delirium Scale

NeurimmiRs and Postoperative Delirium in Elderly Patients Undergoing Total Hip/Knee Replacement: A Pilot Study

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