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World Journal of Surgery

, Volume 34, Issue 3, pp 487–494 | Cite as

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

  • Finn M. Radtke
  • Martin Franck
  • Sabine Schust
  • Lina Boehme
  • Andreas Pascher
  • Hermann J. Bail
  • Matthes Seeling
  • Alawi Luetz
  • Klaus-D. Wernecke
  • Andreas Heinz
  • Claudia D. SpiesEmail author
Article

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.

Keywords

Interrater Reliability Surgical Ward Postoperative Delirium Weighted Estimator Receiver Operating Characteristic Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

This work was funded by Charité–Universitaetsmedizin Berlin.

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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Finn M. Radtke
    • 1
  • Martin Franck
    • 1
  • Sabine Schust
    • 1
  • Lina Boehme
    • 1
  • Andreas Pascher
    • 3
  • Hermann J. Bail
    • 4
  • Matthes Seeling
    • 1
  • Alawi Luetz
    • 1
  • Klaus-D. Wernecke
    • 2
    • 6
  • Andreas Heinz
    • 5
  • Claudia D. Spies
    • 1
    Email author
  1. 1.Department of Anesthesiology and Surgical Intensive Care Medicine, Campus Charité Mitte und Campus Virchow-KlinikumCharité-Universitaetsmedizin BerlinBerlinGermany
  2. 2.SOSTANA GmbHBerlinGermany
  3. 3.Department of Visceral and Transplant SurgeryCharité-Universitaetsmedizin BerlinBerlinGermany
  4. 4.Department of Orthopedic SurgeryCharité-Universitaetsmedizin BerlinBerlinGermany
  5. 5.Department of PsychiatryCharité-Universitaetsmedizin BerlinBerlinGermany
  6. 6.Department of BiometricsCharité-Universitaetsmedizin BerlinBerlinGermany

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