New Cutoff Scores for Delirium Screening Tools to Predict Patient Mortality

Area of Science:

• Critical Care Medicine
• Geriatrics
• Medical Diagnostics

Background:

• Delirium detection is crucial for identifying high-risk patients and predicting adverse outcomes.
• Existing delirium screening instruments lack a consensus on their effectiveness.
• Identifying tools that predict mortality is essential for patient management.

Purpose of the Study:

• To evaluate the effectiveness of different delirium screening instruments in predicting patient mortality.
• To determine optimal cutoff scores for the Confusion Assessment Method for Intensive Care Unit (CAM-ICU), Delirium Rating Scale-Revised-98 (DRS), and Delirium Observation Screening Scale (DOSS) in predicting 365-day mortality.

Main Methods:

• Retrospective cohort study of 1,125 adult inpatients.
• Post hoc analysis of existing data from CAM-ICU, DRS, and DOSS.
• Evaluation of correlations among scales and their relationship with 365-day mortality.

Main Results:

• CAM-ICU positive results correlated with higher DRS and DOSS scores.
• Optimal cutoffs for detecting CAM-ICU positive were DRS = 9/10 and DOSS = 2/3.
• CAM-ICU positive was linked to increased 365-day mortality; DRS = 9/10 and DOSS = 0/1 were most significant in differentiating mortality risk.

Conclusions:

• The optimal DRS and DOSS cutoff scores for predicting 365-day mortality are lower than commonly used thresholds.
• Revised cutoff scores for DRS and DOSS may improve mortality risk differentiation in hospitalized patients.