Delirium: New Scoring System Relates Severity To Hospital Outcomes

Sharon K. Inouye, MD, MPH Professor of Medicine, Harvard Medical School Director, Aging Brain Center, Institute for Aging Research Hebrew SeniorLife both in Boston, MAMedicalResearch.com Interview with:
Sharon K. Inouye, MD, MPH
Professor of Medicine, Harvard Medical School
Director, Aging Brain Center, Institute for Aging Research
Hebrew SeniorLife both in Boston, MA

Study Co- Authors Cyrus Kosar, Douglas Tommet, Eva Schmitt, Margaret Puelle, Jane Saczynski, Edward Marcantonio and Richard Jones. 

MedicalResearch.com: What are the main findings of the study? 

Dr. Inouye: In this study, we developed and validated a new scoring system for delirium severity.  Delirium (acute confusional state) is a common and morbid complication of hospitalization for older persons, which often goes undetected.  Our new scoring system indicates that the severity of delirium is directly related to hospital outcomes, such as length of stay, nursing home placement, death, and healthcare costs.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Inouye: None of the findings were unexpected, but the strength of the associations were more striking than we had anticipated. Thus, delirium was an important and independent prognostic predictor.

MedicalResearch.com: What should clinicians and patients take away from your report? 

Dr. Inouye: The main take-away message is that delirium is an incredibly important condition that should not be missed.  It carries the same mortality as acute myocardial infarction, which is rarely missed.  Yet delirium is routinely missed.  We hope that this article will provide tools to help increase the diagnosis of delirium and rating of its severity as a guide to clinical care.

MedicalResearch.com: What recommendations do you have for future research as a result of this study? 

Dr. Inouye: We believe that the CAM-S will be an important tool to help with future research on delirium.  The CAM-S should be used as an outcome measure for intervention trials and management interventions, prognostic studies, and mechanistic studies.  It provides a means to quantify changes in and recovery from delirium over time.  In addition, the availability of a standardized measure can help to compare results across studies more readily.

 Citation:

The CAM-S: Development and Validation of a New Scoring System for Delirium Severity in 2 Cohorts

Last Updated on April 14, 2014 by Marie Benz MD FAAD