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Delirium detection methodologies: Implications for outcome measurement in clinical trials in postoperative delirium.
Oh, Esther S; Rosenberg, Paul B; Wang, Nae-Yuh; Sieber, Frederick E; Neufeld, Karin J.
Afiliación
  • Oh ES; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Rosenberg PB; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Wang NY; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Sieber FE; Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
  • Neufeld KJ; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Int J Geriatr Psychiatry ; 37(3)2022 03.
Article en En | MEDLINE | ID: mdl-35170079
OBJECTIVE: Delirium is a common postoperative complication of hip fracture. Various methods exist to detect delirium as a reference standard. The goal of this study was to characterize the properties of the measures obtained in a randomized controlled trial, to document their relationship to the Diagnostic and Statistical Manual of Mental Disorders:Text Revision based diagnosis of postoperative delirium by a consensus panel, and to describe the method in detail to allow replication by others. METHODS: A secondary analysis of the randomized trial STRIDE (A Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients) was conducted. Delirium assessments were performed in 200 consecutive hip fracture repair patients ≥65 years old. Assessors underwent extensive training in delirium assessment and the final delirium diagnosis was adjudicated by a consensus panel of three physicians with expertise in delirium assessment. RESULTS: A total of 680 consensus panel delirium diagnoses were completed. There were only 19 (2.8%, 19/678) evaluations where the delirium adjudication by the consensus panel differed from delirium findings by the Confusion Assessment Method (CAM). In 16 (84%, 16/19) of the cases, CAM was negative but the consensus panel diagnosed the patient as having delirium based on all of the available information including the CAM. CONCLUSION: The consensus panel diagnosis was more sensitive compared to CAM alone, however the magnitude of the difference was not large. When assessors are well trained and delirium assessments are closely supervised throughout the study, CAM may be adequate for delirium diagnosis in a clinical trial. Future studies are needed to test this hypothesis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Fracturas de Cadera Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Incidence_studies / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: Int J Geriatr Psychiatry Asunto de la revista: GERIATRIA / PSIQUIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Delirio / Fracturas de Cadera Tipo de estudio: Clinical_trials / Diagnostic_studies / Guideline / Incidence_studies / Prognostic_studies Límite: Aged / Humans Idioma: En Revista: Int J Geriatr Psychiatry Asunto de la revista: GERIATRIA / PSIQUIATRIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido