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A Comparison of Three Scores to Screen for Delirium on the Surgical Ward

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Abstract

Background

Postoperative delirium is associated with adverse outcome. The aim of this study was to find a valid and easy-to-use tool to screen for postoperative delirium on the surgical ward.

Methods

Data were collected from 88 patients who underwent elective surgery. Delirium screening was performed daily until the sixth postoperative day using the Confusion Assessment Method (CAM), the Nursing Delirium Screening Scale (Nu-DESC), and the Delirium Detection Score (DDS), and the DSM-IV criteria as the gold standard.

Results

Seventeen of 88 patients (19%) developed delirium on at least one of the postoperative days according to the gold standard. The DDS scored positive for 40 (45%) patients, the CAM for 15 (17%), and the Nu-DESC for 28 (32%) patients. Sensitivity and specificity were 0.71 and 0.87 for the DDS, 0.75 and 1.00 for the CAM, and 0.98 and 0.92 for the Nu-DESC. The interrater reliability was 0.83 for the Nu-DESC, 0.77 for the DDS, and 1.00 for the CAM.

Conclusions

All scores showed high specificity but differed in their sensitivity. The Nu-DESC proved to be the most sensitive test for screening for a postoperative delirium on the surgical ward followed by the CAM and DDS when compared to the gold standard.

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Acknowledgment

This work was funded by Charité–Universitaetsmedizin Berlin.

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Surgical Intensive Care Medicine, Campus Charité Mitte und Campus Virchow-Klinikum, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Finn M. Radtke, Martin Franck, Sabine Schust, Lina Boehme, Matthes Seeling, Alawi Luetz & Claudia D. Spies

  2. SOSTANA GmbH, Wildensteiner Straße 27, 10318, Berlin, Germany

    Klaus-D. Wernecke

  3. Department of Visceral and Transplant Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany

    Andreas Pascher

  4. Department of Orthopedic Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany

    Hermann J. Bail

  5. Department of Psychiatry, Charité-Universitaetsmedizin Berlin, Berlin, Germany

    Andreas Heinz

  6. Department of Biometrics, Charité-Universitaetsmedizin Berlin, Berlin, Germany

    Klaus-D. Wernecke

Authors
  1. Finn M. Radtke
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  2. Martin Franck
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  3. Sabine Schust
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  4. Lina Boehme
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  5. Andreas Pascher
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  6. Hermann J. Bail
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  7. Matthes Seeling
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  8. Alawi Luetz
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  9. Klaus-D. Wernecke
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  10. Andreas Heinz
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  11. Claudia D. Spies
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Corresponding author

Correspondence to Claudia D. Spies.

Additional information

F. M. Radtke and M. Franck contributed equally to this work.

Appendix

Appendix

See Tables 6, 7, and 8.

Table 6 The Confusion Assessment Method (CAM) [20]
Full size table
Table 7 The Nursing Delirium Screening Scale (Nu-DESC) [19]
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Table 8 The Delirium Detection Score (DDS) [21]
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Radtke, F.M., Franck, M., Schust, S. et al. A Comparison of Three Scores to Screen for Delirium on the Surgical Ward. World J Surg 34, 487–494 (2010). https://doi.org/10.1007/s00268-009-0376-9

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  • DOI: https://doi.org/10.1007/s00268-009-0376-9

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