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Medical Care

New Method Could Help Spot Delirium Quickly

Nurses and doctors may be able to identify delirium easily in hospitalized older adults by asking just two questions. That is the finding of researchers at Pennsylvania State University who published their report online in September 2015 in the Journal of Hospital Medicine. The two questions that proved to have a 93 percent sensitivity in identifying delirium are asking patients what day of the week it is and asking them to recite the months of the year backwards.

A release from the university explains that delirium is a reversible cognitive condition that can be resolved if caught and treated early. The release quotes Donna M. Fick, Distinguished Professor of Nursing and co-director of the Hartford Center of Geriatric Nursing Excellence at Penn State, as saying, “Delirium can be very costly and deadly — and with high-risk patients, time matters. Our ultra-brief two-item bedside test for delirium takes an average of 36 seconds to perform and has a sensitivity of 93 percent.”

Although Edward R. Marcantonio, professor of medicine at Harvard Medical School, recently developed the 3D-CAM with a three-minute confusion assessment method, the Penn State team wanted to develop a method that would be easier to use at the bedside and take less time out of a busy healthcare practitioner’s day. However, if a patient fails to answer the two Penn State questions correctly, the 3D-CAM can be administered to confirm delirium.

Of the 201 participants tested in this study, 42 were clinically diagnosed with delirium. The two-item test identified 48 as possibly delirious — 42 were identified correctly, with 6 false positives. Before the test can be recommended for everyday use, these results “still need to be validated, with a very large sample,” according to Fick, The researchers plan to continue this research in multiple sites with hundreds of participants in the near future to further determine the test’s validity as well as how easily the test can be implemented in real-world situations.


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