Abstract
To determine whether delirium can be diagnosed by telephone, we interviewed 41 subjects aged 65 years or older 1 month after repair of hip fracture, first by telephone and then face-to-face. Interviews included the modified telephone Mini-Mental State Examination and the Delirium Symptom Interview. Delirium was diagnosed using the Confusion Assessment Method diagnostic algorithm, and the telephone results were compared with the face-to-face results (the “gold standard”). Of 41 subjects, 6 were delirious by face-to-face assessment; all 6 were delirious by telephone (sensitivity 1.00). Of 35 patients not delirious by face-to-face assessment, 33 patients were not delirious by telephone (specificity=0.94). We conclude that telephone interviews can effectively rule out delirium, but the positive diagnosis should be confirmed by a face-to-face assessment, especially in populations with a low prevalence of delirium.
This is a preview of subscription content, log in via an institution to check access.
References
Francis J. Delirium in older patients. J Am Geriatr Soc. 1992;40:829–38.
Levkoff SE, Evans DA, Liptzin B, et al. Delirium: occurrence and persistence of symptoms among elderly hospitalized patients. Arch Intern Med. 1992;152:334–40.
Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the Confusion Assessment Method. Ann Intern Med. 1990;113:941–8.
Albert MS, Levkoff SE, Reilly C, et al. The Delirium Symptom Interview: an interview for the detection of delirium symptoms in hospitalized patients. J Geriatr Psych Neurol. 1992;5:14–21.
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.
Rocaforte WH, Burke WJ, Bayer BL, Wengel SP. Validation of a telephone version of the Mini-Mental State Examination. J Am Geriatr Soc. 1992;40:697–702.
Rosner B. Fundamentals of Biostatistics. 3rd ed. Boston, Mass: PWS-Kent Publishing Company; 1990.
Hennekens CH, Buring JE. Epidemiology in Medicine. Boston, Mass: Little, Brown and Company; 1987.
Murray AM, Levkoff SE, Wetle TT, et al. Acute delirium and functional decline in the hospitalized elderly patient. J Gerontol. 1993;48:181–6.
Wasson JH, Gaudette C, Whaley F, Sauvigne A, Baribeau P, Welch HC. Telephone care as a substitute for routine clinic follow-up. JAMA. 1992;267:1788–93.
Author information
Authors and Affiliations
Additional information
This work was funded by a pilot project grant from the Older Americans Independence Center, P60 AG08812-06; an Academic Award from the National Institute on Aging, K08-AG00648; and a postdoctoral fellowship from the Medical Foundation: Charles A. King Trust.
Rights and permissions
About this article
Cite this article
Marcantonio, E.R., Michaels, M. & Resnick, N.M. Diagnosing delirium by telephone. J GEN INTERN MED 13, 621–623 (1998). https://doi.org/10.1046/j.1525-1497.1998.00185.x
Issue Date:
DOI: https://doi.org/10.1046/j.1525-1497.1998.00185.x