A new delirium severity score proves accurate for predicting important clinical outcomes in hospitalized patients, according to an article published in Annals of Internal Medicine.
Delirium is common among hospitalized patients and is associated with poor outcomes. The Confusion Assessment Method (CAM) is a standardized, validated measure that is widely used to screen for the presence of delirium but not its severity. Researchers hypothesized that adding a valid delirium severity measure to the CAM algorithm would be a strong independent predictor of adverse outcomes, such as prolonged hospital stay, functional and cognitive decline, nursing home placement, death, and high health care costs. They developed the CAM-S scoring system and conducted a validation analysis on two independent cohorts - 300 patients aged 70 years and older scheduled for major surgery and 919 medical patients aged 70 and older. Patients with CAM-diagnosed delirium were given a score for features such as inattention, disorganized thinking, and altered level of consciousness. The maximum CAM-S score given during hospitalization was evaluated against hospital and post-hospital outcomes.
The study showed that the CAM-S has good psychometric properties; high inter-rater reliability; and strong association with clinical outcomes related to delirium. The researchers conclude that the CAM-S is a reliable means for rating delirium severity and could be helpful in both research and clinical settings.
Article: The CAM-S: Development and Validation of a New Scoring System for Delirium Severity in 2 Cohorts, S.K. Inouye, C.M. Kosar, D. Tommet, E.M. Schmitt, M.R. Puelle, J.S. Saczynski, E.R. Marcantonio, and R.N. Jones, Annals of Internal Medicine, DOI: 10.7326/M13-1927, published online 14 April 2014.