title: A comparison of three scores to screen for delirium on the surgical ward.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Surgical Intensive Care Medicine, Campus Charité Mitte, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Finn M
authors.initials: FM
authors.lastname: Radtke
authors.forename: Martin
authors.initials: M
authors.lastname: Franck
authors.forename: Sabine
authors.initials: S
authors.lastname: Schust
authors.forename: Lina
authors.initials: L
authors.lastname: Boehme
authors.forename: Andreas
authors.initials: A
authors.lastname: Pascher
authors.forename: Hermann J
authors.initials: HJ
authors.lastname: Bail
authors.forename: Matthes
authors.initials: M
authors.lastname: Seeling
authors.forename: Alawi
authors.initials: A
authors.lastname: Luetz
authors.forename: Klaus-D
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Spies
mesh_terms: 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