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Geriatr Nurs. 2017 Nov - Dec;38(6):567-572. doi: 10.1016/j.gerinurse.2017.04.006. Epub 2017 May 19.

Predicting inpatient delirium: The AWOL delirium risk-stratification score in clinical practice.

Author information

1
Department of Neurology, University of California, San Francisco, USA. Electronic address: ethan.brown@ucsf.edu.
2
Department of Neurology, University of California, San Francisco, USA.
3
Department of Neurology, University of California, Irvine, USA.
4
Department of Neurology, University of California, San Francisco, USA. Electronic address: vanja.douglas@ucsf.edu.

Abstract

Inpatient delirium improves with multicomponent interventions by hospital staff, though the resources needed are often limited. Risk-stratification to predict delirium is a useful first step to help triage resources, but the performance of risk-stratification as part of a functioning multicomponent pathway has not been assessed. We retrospectively studied the performance of a validated delirium prediction rule, the AWOL score, as a part of a multicomponent delirium care pathway in practice on a university hospital ward. We reviewed the hospitalizations of patients 50 years or older for evidence of delirium and extracted the AWOL score from nursing documentation (n = 347). The area under the receiver operating characteristic curve (AUC) was 0.83 (95% CI 0.77-0.89) for all cases and 0.73 (95% CI 0.60-0.85) when cases of prevalent delirium were removed. Involving minimal additional assessment, this nursing-based risk stratification score performed well as part of a multicomponent delirium care pathway.

KEYWORDS:

Clinical prediction rule; Delirium; Hospitalization

PMID:
28533062
DOI:
10.1016/j.gerinurse.2017.04.006
[Indexed for MEDLINE]

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