Delirium in liver transplantation candidates: discriminant analysis of multiple test variables.
We report the results of electroencephalograms, Mini-Mental State exam, Trailmaking Tests A and B, and serum albumin levels in 108 consecutive liver transplantation candidates. We compared test results to a clinical DSM-III diagnosis of delirium. Although each variable could differentiate between the two groups (delirium n = 18; nondelirium n = 90) at a statistically significant level, a discriminant analysis involving either all variables or only three particular variables (Trailmaking B, EEG code, and albumin) resulted in the highest specificity (97.8%) and sensitivity (83.3%), with a correct classification of 95.4% of subjects. The analysis also generates an equation that can be applied to clinical situations to enhance the accurate recognition of delirium. In addition, to explain abnormal Trailmaking B scores and/or EEGs in subjects who did not otherwise meet DSM-III criteria for delirium, we suggest the presence of a "subclinical delirium."
Trzepacz
P T
PT
Department of Psychiatry, University of Pittsburgh, School of Medicine, PA.
Brenner
R P
RP
Coffman
G
G
van Thiel
D H
DH
D000293:Adolescent; D000328:Adult; D003693:Delirium / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006501:Hepatic Encephalopathy / Q000175:diagnosis*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008370:Manuals as Topic; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis*; D011597:Psychomotor Performance; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism
D012709:Serum Albumin