Stoevelaar et al reported a risk score list to identify an inpatient hospice patient at risk for delirium. The authors are from Leiden University, Netherlands Comprehensive Cancer Organisation, and Hospice Duin en Bollenstreek in The Netherlands.
Patient selection: inpatient hospice
Parameters:
(1) previous delirium
(2) cognitive impairment
(3) opioid change
(4) age in years
(5) use of alcohol in units per day
(6) recreational drug use
(7) body temperature in °C
(8) metabolic disorder
(9) hearing and/or vision problems
(10) procedure requiring anesthesia
Parameter
Finding
Points
previous delirium
no
0
yes
3
cognitive impairment
no
0
yes
3
opioid change
no
0
yes
3
age in years
<= 70 years
0
> 70 years
1
alcohol use
<= 4 units per day
0
> 4 units per day
1
recreational drug use
no
0
yes
1
body temperature
<= 38.0°C
0
> 38.0°C
1
metabolic disorder
no
0
yes
1
hearing and/or vision disorder
no
0
yes
1
procedure with anesthesia
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
Total Score
Risk Category
Recommendations
0 to 2
low
care as usual; monitor for delirium
3 to 6
moderate
monitor for delirium; inform patient and family of risk
7 to 16
high
monitor for delirium; consider preventive measures
Performance:
• The area under the ROC curve is 0.64, which is suboptimal.
• The sensitivity was 0.85 with specificity 0.43.
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