Validating a new clinical subtyping scheme for delirium with electronic motion analysis

Godfrey, Alan; Leonard, Maeve; Donnelly, Sinéad; Conroy, Marion; ÓLaighin, Gearóid; Meagher, David

doi:10.1016/j.psychres.2009.04.010

Cited by 46 publications

(51 citation statements)

References 30 publications

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“…This is a 13-item, clinician-rated scale that allows for subtype attribution that has demonstrated concurrent and predictive validity (18). It was originally developed in palliative care patients but has also been validated in CL-Psychiatry and elderly medical and surgical patients.…”

Section: Delirium Motor Subtype Scalementioning

confidence: 99%

Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study

Uchida

Okuyama

Ito

et al. 2015

Jpn. J. Clin. Oncol.

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Objective: The aim of this study was to investigate the prevalence of delirium on admission, the course of delirium during a 2-week period after admission and factors associated with delirium on admission, among elderly patients with advanced cancer. Methods: Patients aged ≥65 years with incurable lung or gastroenterological cancer and the Eastern Cooperative Oncology Group Performance Status 2 or greater were continuously sampled after admission to a university hospital. Participants were evaluated for DSM-IV-TR delirium by trained psychiatrists and the delirium subtype was assessed using the Delirium Motor Subtype Scale within 4 days after admission and again 2 weeks later. In addition, we assessed associated factors with delirium on admission. Results: Among 73 eligible patients, complete data were available from 61 on admission and 49 after 2 weeks. Twenty-six patients (43%) met delirium criteria on admission (hypoactive: 58%, unspecified: 35%, hyperactive: 4%, mixed: 4%). Of these, 19 (73%) remained delirious 2 weeks later. Of 35 patients without delirium on admission, 21 (60%) remained delirium-free 2 weeks later and 7(20%) became delirious. Overall, 33/61 (54%) developed delirium at some point during the study. Patients receiving steroids at admission were more likely to have delirium (odds ratio = 5.0; 95% confidence interval = 1.5-16). Conclusions: Given the high prevalence of the delirium, all patients with advanced cancer should be screened for delirium both on admission and regularly thereafter. In addition, medical staff should be aware that steroid use on admission is an additional indicator of elevated risk for delirium.

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Section: Delirium Motor Subtype Scalementioning

confidence: 99%

Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study

Uchida

Okuyama

Ito

et al. 2015

Jpn. J. Clin. Oncol.

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“…Some authors have also used RASS for motor subtyping. Recently electronic motor analysis has also been used for motor subtyping [71] . Recently, Meagher et al [44] collated 30 clinical features used in different subtyping methods to define motor subtypes and developed a Delirium Motor Checklist (DMC).…”

Section: Instruments For Assessment Of Motor Symptoms Of Deliriummentioning

confidence: 99%

Assessment scales for delirium: A review

Grover

Kate²

2012

WJP

155

128

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Over the years many scales have been designed for screening, diagnosis and assessing the severity of delirium. In this paper we review the various instruments available to screen the patients for delirium, instruments available to diagnose delirium, assess the severity, cognitive functions, motoric subtypes, etiology and associated distress. Among the various screening instruments, NEECHAM confusion scale and delirium observation scale appear to be most suitable screening instrument for patients' in general medical and surgical wards, depending on the type of rater (physician or nurse). In general, the instruments which are used for diagnosis [i.e., confusion assessment method (CAM), CAM for intensive care unit (CAM-ICU), Delirium Rating Scale-revised version (DRS-R-98), memorial selirium assessment scale, etc. ] are based on various Diagnostic and Statistical Manual criteria and have good to excellent reliability and fair to good validity. Among the various diagnostic instruments, CAM is considered to be most useful instrument because of its accuracy, brevity, and ease of use by clinicians and lay interviewers. In contrast, DRS-R-98 appears to be a comprehensive instrument useful for diagnosis, severity rating and is sensitive to change and hence can be used for monitoring patients over a period. In the ICU setting, evidence suggests that CAM-ICU and Nursing Delirium Screening Scale had comparable sensitivities, but CAM-ICU has higher specificity. With regard to assessment of delirium in pediatric age group, certain instruments like Pediatric Anesthesia Emergence Delirium scale and pediatric CAM-ICU has been designed and have been found to be useful.

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“…The Delirium Motor Subtype Scale (DMSS) [7] is a scale using 11 motor items derived from items used in previous motor subtyping methods but with relative specificity for delirium and demonstrated correlation with objective measures of motor behaviour, including electronic motion analysis [8]. It can be rated by any healthcare professional who is familiar with patient behaviour and can be used to rate the previous 24 h or more.…”

Section: Assessmentsmentioning

confidence: 99%

“…Meagher et al [7] validated a new motor subtype scale, the Delirium Motor Subtype Scale (DMSS), focused only on motor features and which differentiated delirious from nondelirious subjects. Moreover, subsequent work has indicated that DMSS defined subtypes match objective (electronic) measures of motion [8]. Subtypes identified cross-sectionally using the DMSS had comparable neuropsychological profiles but differed for noncognitive symptoms of delirium [9].…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

Meagher

Leonard

Donnelly³

et al. 2012

Journal of Psychosomatic Research

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104

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Validating a new clinical subtyping scheme for delirium with electronic motion analysis

Cited by 46 publications

References 30 publications

Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study

Prevalence, course and factors associated with delirium in elderly patients with advanced cancer: a longitudinal observational study

Assessment scales for delirium: A review

A longitudinal study of motor subtypes in delirium: Frequency and stability during episodes

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