title: Predictive value and validation of the NEECHAM Confusion Scale using DSM-IV criteria for delirium as gold standard.
abstract: BACKGROUND
  Delirium is common among older people in hospital and various instruments have been developed for detecting delirium. One of these, the NEECHAM Confusion Scale, is easy for nurses to administrate but needs to be tested further.
  
  
  OBJECTIVE
  The aim of the present study was to assess the validity and predictive value of the NEECHAM Confusion Scale.
  
  
  METHODS
  The study was conducted among 149 patients aged ≥ 65, who had undergone surgery for a hip fracture. The patients were observed daily using DSM-IV criteria for delirium. The NEECHAM Confusion Scale was performed upon admission and prior to discharge.
  
  
  RESULTS
  The incidence of DSM-IV related delirium was 24%. Patients who scored below 25 points on the NEECHAM scale had a 12 times higher risk of developing DSM-IV related delirium. During admission, the sensitivity of NEECHAM was zero because all patients with DSM-IV delirium were excluded, the specificity was 75%. On discharge, it was 100% and 91% respectively.
  
  
  CONCLUSIONS
  This study adds to the body of knowledge that NEECHAM discriminates for delirium. It is a valid and reliable screening instrument for predicting delirium. The instrument can be used for clinical practice to identify patients who are at risk of contracting delirium and when considering prevention measures.
authors.affiliation: Department of Health and Social Sciences, Högskolan Dalarna, Falun, Sweden. gsd@du.se
authors.forename: Gill
authors.initials: G
authors.lastname: Sörensen Duppils
authors.forename: Inger
authors.initials: I
authors.lastname: Johansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology / Q000451:nursing*; D003953:Diagnosis-Related Groups; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D005851:Geriatric Nursing / Q000379:methods*; D006620:Hip Fractures / Q000453:epidemiology / Q000451:nursing / Q000523:psychology; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards; D009730:Nursing Assessment / Q000379:methods / Q000592:standards*; D011237:Predictive Value of Tests; D012015:Reference Standards; D015203:Reproducibility of Results; D012307:Risk Factors