title: The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts.
abstract: BACKGROUND
  Quantifying the severity of delirium is essential to advancing clinical care by improved understanding of delirium effect, prognosis, pathophysiology, and response to treatment.
  
  
  OBJECTIVE
  To develop and validate a new delirium severity measure (CAM-S) based on the Confusion Assessment Method.
  
  
  METHODS
  Validation analysis in 2 independent cohorts.
  
  
  METHODS
  Three academic medical centers.
  
  
  METHODS
  The first cohort included 300 patients aged 70 years or older scheduled for major surgery. The second included 919 medical patients aged 70 years or older.
  
  
  METHODS
  A 4-item short form and a 10-item long form were developed. Association of the maximum CAM-S score during hospitalization with hospital and posthospital outcomes related to delirium was evaluated.
  
  
  RESULTS
  Representative results included adjusted mean length of stay, which increased across levels of short-form severity from 6.5 days (95% CI, 6.2 to 6.9 days) to 12.7 days (CI, 11.2 to 14.3 days) (P for trend &lt; 0.001) and across levels of long-form severity from 5.6 days (CI, 5.1 to 6.1 days) to 11.9 days (CI, 10.8 to 12.9 days) (P for trend &lt; 0.001). Representative results for the composite outcome of adjusted relative risk of death or nursing home residence at 90 days increased progressively across levels of short-form severity from 1.0 (referent) to 2.5 (CI, 1.9 to 3.3) (P for trend &lt; 0.001) and across levels of long-form severity from 1.0 (referent) to 2.5 (CI, 1.6 to 3.7) (P for trend &lt; 0.001).
  
  
  CONCLUSIONS
  Data on clinical outcomes were measured in an older data set limited to patients aged 70 years or older.
  
  
  CONCLUSIONS
  The CAM-S provides a new delirium severity measure with strong psychometric properties and strong associations with important clinical outcomes.
  
  
  BACKGROUND
  National Institute on Aging.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.|Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Inouye
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.
authors.forename: Cyrus M
authors.initials: CM
authors.lastname: Kosar
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.
authors.forename: Douglas
authors.initials: D
authors.lastname: Tommet
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Schmitt
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Puelle
authors.affiliation: Division of Geriatric Medicine and Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.affiliation: Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife.|Departments of Psychiatry and Human Behavior and Neurology, Brown University Warren Alpert Medical School, Providence RI.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis; D003693:Delirium / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D009735:Nursing Homes; D011581:Psychological Tests; D011594:Psychometrics; D012720:Severity of Illness Index
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