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Confusion Assessment Method Adapted to Measure Delirium Severity — Physician’s First Watch

Medical News |
April 15, 2014

Confusion Assessment Method Adapted to Measure Delirium Severity

By Joe Elia

A scoring system to measure a patient's delirium severity, based on the widely used Confusion Assessment Method (or CAM), shows promise as an indicator of clinical outcome, according to an Annals of Internal Medicine study.

The new severity score, called CAM-S, was developed in some 300 patients aged 70 and older undergoing major noncardiac surgery, and then was validated in 900 elderly patients admitted to a medical service. The system has a short and a long form (4 and 10 questions, respectively) that can be graded at bedside. The measured features include inattention, disorganized thinking, sleep disturbances, and perceptual disturbances, with scores ranging from 0 to 7 (short form) and 0 to 19 (long).

Increasing severity scores were associated with increasing lengths of stay and increasing risks for death or nursing home residence by the 90-day mark.

Editorialists call CAM-S scores a "powerful prognostic sign."

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