title: Using the Chinese version of Memorial Delirium Assessment Scale to describe postoperative delirium after hip surgery.
abstract: OBJECTIVE
  Memorial Delirium Assessment Scale (MDAS) assesses severity of delirium. However, whether the MDAS can be used in a Chinese population is unknown. Moreover, the optimal postoperative MDAS cutoff point for describing postoperative delirium in Chinese remains largely to be determined. We therefore performed a pilot study to validate MDAS in the Chinese language and to determine the optimal postoperative MDAS cutoff point for delirium.
  
  
  METHODS
  Eighty-two patients (80 ± 6 years, 21.9% male), who had hip surgery under general anesthesia, were enrolled. The Confusion Assessment Method (CAM) and Mini-Mental State Examination (MMSE) were administered to the patients before surgery. The CAM and MDAS were performed on the patients on the first, second and fourth postoperative days. The reliability and validity of the MDAS were determined. A receiver operating characteristic (ROC) curve was used to determine the optimal Chinese version MDAS cutoff point for the identification of delirium.
  
  
  RESULTS
  The Chinese version of the MDAS had satisfactory internal consistency (α = 0.910). ROC analysis obtained an average optimal MDAS cutoff point of 7.5 in describing the CAM-defined postoperative delirium, with an area under the ROC of 0.990 (95% CI 0.977-1.000, P < 0.001).
  
  
  CONCLUSIONS
  The Chinese version of the MDAS had good reliability and validity. The patients whose postoperative Chinese version MDAS cutoff point score was 7.5 would likely have postoperative delirium. These results have established a system for a larger scale study in the future.
authors.affiliation: Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China ; Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Zhongyong
authors.initials: Z
authors.lastname: Shi
authors.affiliation: Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China ; Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Shukun
authors.initials: S
authors.lastname: Fu
authors.affiliation: Department of Orthopedic Surgery, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Guodong
authors.initials: G
authors.lastname: Li
authors.affiliation: School of Medicine, Tongji University Shanghai, China.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School Charlestown, MA, USA.
authors.forename: Celeste A
authors.initials: CA
authors.lastname: Swain
authors.affiliation: Divisions of General Medicine and Primary Care and Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School Boston, MA, USA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Marcantonio
authors.affiliation: Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School Charlestown, MA, USA.
authors.forename: Zhongcong
authors.initials: Z
authors.lastname: Xie
authors.affiliation: Department of Psychiatry, Tenth People's Hospital of Tongji University Shanghai, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shen
keywords: Chinese; confusion assessment method; hip surgery; memorial delirium assessment scale; postoperative delirium