A comparison of three scores to screen for delirium on the surgical ward.
BACKGROUND
Postoperative delirium is associated with adverse outcome. The aim of this study was to find a valid and easy-to-use tool to screen for postoperative delirium on the surgical ward.


METHODS
Data were collected from 88 patients who underwent elective surgery. Delirium screening was performed daily until the sixth postoperative day using the Confusion Assessment Method (CAM), the Nursing Delirium Screening Scale (Nu-DESC), and the Delirium Detection Score (DDS), and the DSM-IV criteria as the gold standard.


RESULTS
Seventeen of 88 patients (19%) developed delirium on at least one of the postoperative days according to the gold standard. The DDS scored positive for 40 (45%) patients, the CAM for 15 (17%), and the Nu-DESC for 28 (32%) patients. Sensitivity and specificity were 0.71 and 0.87 for the DDS, 0.75 and 1.00 for the CAM, and 0.98 and 0.92 for the Nu-DESC. The interrater reliability was 0.83 for the Nu-DESC, 0.77 for the DDS, and 1.00 for the CAM.


CONCLUSIONS
All scores showed high specificity but differed in their sensitivity. The Nu-DESC proved to be the most sensitive test for screening for a postoperative delirium on the surgical ward followed by the CAM and DDS when compared to the gold standard.
Radtke
Finn M
FM
Department of Anesthesiology and Surgical Intensive Care Medicine, Campus Charité Mitte, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Franck
Martin
M
Schust
Sabine
S
Boehme
Lina
L
Pascher
Andreas
A
Bail
Hermann J
HJ
Seeling
Matthes
M
Luetz
Alawi
A
Wernecke
Klaus-D
KD
Heinz
Andreas
A
Spies
Claudia D
CD
D000368:Aged; D003693:Delirium / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000175:diagnosis*; D012680:Sensitivity and Specificity