A new test could reveal delirium in as little as three minutes, leading to easier treatment of the condition.
Delirium is a state of confusion that has a sudden onset and usually occurs after either a mental or physical medical event, Beth Israel Deaconess Medical Center reported. The condition often goes undetected and can come with serious consequences. This new three-minute diagnostic assessment has proven to be extremely accurate in identifying delirium in elderly patients.
"Prompt recognition of delirium is the first step to timely evaluation and treatment, preventing complications and keeping older patients safe while in the hospital," said lead author Edward Marcantonio, MD, SM, Director of the Aging Research Program in the Division of General Medicine and Primary Care at BIDMC and Professor of Medicine at Harvard Medical School. "As growing numbers of older adults are being hospitalized, it's critically important that doctors, nurses and other hospital care providers be able to recognize delirium."
The test, dubbed CAM-Defined Delirium (3D-CAM), detected the condition with greater-than-90-percent specificity and sensitivity when compared with the standard. 3D-CAM looks for four factors: acute change and fluctuating course; inattention; disorganized thinking; and altered level of consciousness.
Delirium affects between 30 and 40 percent of older medical patients and between 15 and 50 percent of elderly surgery patients.
"We have found that there are many different cognitive tests that the person rating the CAM can use to assess for these four features, and we've shown that the quality of the assessment makes a big difference in the accuracy of identification of delirium," said senior author Sharon K. Inouye, Director of the Aging Brain Center in the Institute for Aging Research at Hebrew Senior Life and HMS Professor of Medicine in the Division of Gerontology at BIDMC. "The 3D-CAM is a major advance since it provides a brief, easy-to-administer approach that operationalizes the CAM algorithm in three minutes, and provides highly accurate results compared to a gold standard clinical assessment."
The findings were published Oct. 21 in the Annals of Internal Medicine.
