The delirium screening tool 4AT in routine clinical practice: prediction of mortality, sensitivity and specificity

• DOI: 10.1007/s41999-021-00489-1
• Publication Date: 2021-04-04T05:02:32Z
• Authors: Sigurd Evensen; Anette Hylen Ranhoff; Stian Lydersen; Ingvild Saltvedt
• Keywords: Aged, 80 and over; 2. Zero hunger; 610; Delirium; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Activities of Daily Living; Humans; Female; Prospective Studies; Geriatric Assessment; Research Paper; Aged

Delirium is common and associated with poor outcomes, partly due to underdetection. We investigated if the delirium screening tool 4 A's test (4AT) score predicts 1 year mortality explored sensitivity specificity of 4AT when applied as part a clinical routine.Secondary analyses prospective study 228 patients acutely admitted Medical Geriatric Ward. Physicians without formal training conducted index (the 4AT); predefined cut-off ≥ suggested delirium. Reference standard was diagnosed by two geriatricians using Diagnostic Statistical Manual Mental Disorders 5 (DSM-5). calculated hazard ratios (HR) Cox regression based on groups = 0, 1-3, 4-7 8, first unadjusted, then adjusted for covariates age, comorbidity, personal activities daily living. sensitivity, specificity, area under receiver operating curve (AUC).Mean age 86.6 years, 139 (61.0%) were female, 78 (34.2%) had DSM-5 delirium; these, 56 4AT-delirium. 27.6% (63 patients). Compared group 8 increased (HR 2.86, 95% confidence interval 1.28-6.37, p 0.010). The effect reduced in multiadjusted 1.69, 0.70-4.07, 0.24). Sensitivity, AUC 0.72, 0.84, 0.88, respectively.4AT indicates mortality, but analyses. acceptable routine.