Features for method:
(1) mental status change
(2) inattention
(3) disorganized thinking
(4) altered level of consciousness
Feature 1: Acute onset of mental status changes or a fluctuating course
Feature 2: Inattention, as indicated by difficulty focusing attention and/or a reduced ability to maintain and shift attention
Feature 3: Disorganized thinking
Feature 4: Altered level of consciousness
|
Level of Consciousness
|
Description
|
|
alert
|
normal, spontaneously fully aware of environment, interacts appropriately
|
|
vigilant
|
hyperalert
|
|
lethargic
|
drowsy but easily aroused;
unaware of some elements of the environment, or not spontaneously interacting with the interviewer;
becomes fully aware and appropriately interactive when prodded minimally
|
|
stupor
|
difficult to arouse
unaware of some or all elements of the environment, or not spontaneously interacting with interviewer;
becomes incompletely aware and inappropriately interactive when prodded strongly
|
|
coma
|
unarousable;
unaware of all elements of the environment, with no spontaneous interaction or awareness of the interviewer;
interview difficult or impossible even with maximal prodding
|
Delirium is present if:
(1) feature 1 is present, AND
(2) feature 2 is present, AND
(3) feature 3 OR feature 4 is present
Performance (Critical Care Medicine, page 1370):
• Inter-rater reliability high, with kappa statistics ranging from 0.79 to 0.95.
• The instrument showed a good correlation with the reference standard.
• Sensitivity ranged from 95-100% and specificity ranged from 89-93%.
