Development of the AL-O-A Score for Delirium Screening in Acute Internal Medicine: a Monocentric Prospective Study.

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Serval ID
serval:BIB_2FE60B62EB05
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Development of the AL-O-A Score for Delirium Screening in Acute Internal Medicine: a Monocentric Prospective Study.
Journal
Journal of general internal medicine
Author(s)
John G., Bovet V., Verdon V., Zender H., Donzé J.
ISSN
1525-1497 (Electronic)
ISSN-L
0884-8734
Publication state
Published
Issued date
07/2021
Peer-reviewed
Oui
Volume
36
Number
7
Pages
1980-1988
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Delirium occurs frequently in acute internal medicine wards and may worsen the patient's prognosis; it deserves a fast, systematic screening tool.
Develop a delirium screening score for inpatients admitted to acute internal medicine wards.
A monocentric prospective study between November 2019 and January 2020.
Two hundred and seventeen adult inpatients.
Within 48 h of hospital admission, physicians administered an index test to participants which explored potential predictors associated with the fluctuation of mental state, inattention, disorganised thinking and altered level of consciousness. On the same day, patients underwent a neuropsychological evaluation (reference standard) to assess for delirium. The score was constructed using a backward stepwise logistic regression strategy. Areas under the receiver operating curves (AUC) and calibration curves were drawn to calculate the score's performance. The score was tested on subgroups determined by age, sex and cognitive status.
The AL-O-A score ("abnormal or fluctuating ALertness, temporospatial Orientation and off-target Answers") showed excellent apparent (AUC 0.95 (95% CI 0.91-0.99)) and optimism-corrected discrimination (AUC 0.92 (95% CI 0.89-0.96)). It performed equally well in subgroups with and without cognitive impairment (AUC 0.93 (95% CI 0.88-0.99) vs 0.92 (95% CI 0.80-0.99)); in men and women (AUC 0.96 (95% CI 0.94-0.99) vs 0.95 (95% CI 0.89-0.99)); and in patients younger and older than 75 years old (AUC 0.98 (95% CI 0.95-0.99) vs 0.93 (95% CI 0.87-0.99)).
A simple, 1-min screening test (AL-O-A score), even administered by an untrained professional, can identify delirium in internal medicine patients.
Keywords
Adult, Aged, Delirium/diagnosis, Delirium/epidemiology, Female, Hospitalization, Humans, Inpatients, Male, Mass Screening, Prospective Studies, adult, delirium, inpatients, internal medicine, prospective study, score
Pubmed
Web of science
Open Access
Yes
Create date
08/02/2021 8:56
Last modification date
08/08/2024 6:31
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