Delirium assessment tools among hospitalized older adults: A systematic review and metaanalysis of diagnostic accuracy

Chia Jou Lin, I. Chang Su, Sheng Wen Huang, Pin Yuan Chen, Victoria Traynor, Hui Chen (Rita) Chang, I. Hsing Liu, Yun Shuan Lai, Hsin Chien Lee, Kaye Rolls, Hsiao Yean Chiu

研究成果: 雜誌貢獻回顧型文獻同行評審

1 引文 斯高帕斯(Scopus)


Delirium is a common neuropsychiatric syndrome that is often overlooked in clinical settings. The most accurate instrument for screening delirium has not been established. This study aimed to compare the diagnostic accuracy of the 4 'A's Test (4AT), Nursing Delirium Screening Scale (Nu-DESC), and Confusion Assessment Method (CAM) in detecting delirium among older adults in clinical settings. These assessment tools feature concise item sets and straightforward administration procedures. Five electronic databases were systematically searched from their inception to September 7, 2022. Studies evaluating the sensitivity and specificity of the 4AT, Nu-DESC, and CAM against the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases as the reference standard were included. Bivariate random effects model was used to summarize the sensitivity and specificity results. A total of 38 studies involving 7378 patients were included. The 4AT, Nu-DESC, and CAM had comparable sensitivity in detecting delirium (0.76, 0.78, and 0.80, respectively). However, the specificity of the CAM was higher than that of the 4AT (0.98 vs 0.89, P =.01) and Nu-DESC 0.99 vs 0.90, P =.003). Diagnostic accuracy was moderated by the percentage of women, acute care setting, sample size, and assessors. The three tools exhibit comparable sensitivity, and the CAM has the highest specificity. Based on the feasibility of the tools, nurses and clinical staffs could employ the Nu-DESC and the 4AT on screening out positive delirium cases and integrate these tools into daily practice. Further investigations are warranted to verify our findings.
期刊Ageing Research Reviews
出版狀態已發佈 - 9月 2023

ASJC Scopus subject areas

  • 生物技術
  • 生物化學
  • 老化
  • 分子生物學
  • 神經內科


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