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Validation of an automated delirium prediction model (DElirium MOdel (DEMO)): an observational study.
Mestres Gonzalvo, Carlota; de Wit, Hugo A J M; van Oijen, Brigit P C; Deben, Debbie S; Hurkens, Kim P G M; Mulder, Wubbo J; Janknegt, Rob; Schols, Jos M G A; Verhey, Frans R; Winkens, Bjorn; van der Kuy, Paul-Hugo M.
Afiliación
  • Mestres Gonzalvo C; Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • de Wit HAJM; Department of Clinical Pharmacy, Elkerliek Hospital, Helmond, The Netherlands.
  • van Oijen BPC; Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • Deben DS; Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
  • Hurkens KPGM; Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • Mulder WJ; Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • Janknegt R; Section of Geriatric Medicine, Department of Internal Medicine, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • Schols JMGA; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
  • Verhey FR; Department of Clinical Pharmacy, Pharmacology and Toxicology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
  • Winkens B; Department of Family Medicine and Department of Health Services Research, CAPHRI-School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
  • van der Kuy PM; Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg/School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.
BMJ Open ; 7(11): e016654, 2017 Nov 08.
Article en En | MEDLINE | ID: mdl-29122789
OBJECTIVES: Delirium is an underdiagnosed, severe and costly disorder, and 30%-40% of cases can be prevented. A fully automated model to predict delirium (DEMO) in older people has been developed, and the objective of this study is to validate the model in a hospital setting. SETTING: Secondary care, one hospital with two locations. DESIGN: Observational study. PARTICIPANTS: The study included 450 randomly selected patients over 60 years of age admitted to Zuyderland Medical Centre. Patients who presented with delirium on admission were excluded. PRIMARY OUTCOME MEASURES: Development of delirium through chart review. RESULTS: A total of 383 patients were included in this study. The analysis was performed for delirium within 1, 3 and 5 days after a DEMO score was obtained. Sensitivity was 87.1% (95% CI 0.756 to 0.939), 84.2% (95% CI 0.732 to 0.915) and 82.7% (95% CI 0.734 to 0.893) for 1, 3 and 5 days, respectively, after obtaining the DEMO score. Specificity was 77.9% (95% CI 0.729 to 0.882), 81.5% (95% CI 0.766 to 0.856) and 84.5% (95% CI 0.797 to 0.884) for 1, 3 and 5 days, respectively, after obtaining the DEMO score. CONCLUSION: DEMO is a satisfactory prediction model but needs further prospective validation with in-person delirium confirmation. In the future, DEMO will be applied in clinical practice so that physicians will be aware of when a patient is at an increased risk of developing delirium, which will facilitate earlier recognition and diagnosis, and thus will allow the implementation of prevention measures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación Geriátrica / Delirio / Modelos Psicológicos Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMJ Open Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Evaluación Geriátrica / Delirio / Modelos Psicológicos Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: BMJ Open Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido