Delirium Risk Score in an Elderly Patient at Hospital Discharge

Description

Inouye et al developed a simple risk score for predicting if an elderly patient who develops delirium as a hospital inpatient will be discharged with delirium. This can help identify a patient who may require more aggressive management. The authors are from Beth Israel Deaconess Medical Center, Harvard University, Hebrew SeniorLife and Brigham and Women's Hospital.

Patient selection: age >= 70 years AND admitted without delirium AND developed delirium in the hospital

Parameters:

(1) dementia

(2) vision

(3) functional impairment

(4) comorbidity (based on the Charlson comorbidity score)

(5) physical restraint during hospital delirium

Parameter	Finding	Points
dementia	absent	0
	present	1
vision	not impaired	0
	impaired	1
functional impairment	none or 1 activity of daily living	0
	>= 2 ADL	1
comorbidity	Charlson < 4	0
	Charlson >= 4	1
physical restraint for delirium	not used	0
	used	1

where:

• Visual impairment was defined as a corrected near vision worse than 20/70.

• Dementia was based on the Blessed Dementia Rating Scale (score >= 4).

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the more likely the person is to be delirious at discharge.

Total Score	Risk of Delirium	Percent Affected
0 or 1	low	4%
2 or 3	intermediate	18%
4 or 5	high	63%

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Description

Specialty

Objective

ICD-10

Model of Inouye et al for Predicting Delirium in an Elderly Patient at Hospital Discharge

Purpose: To determine the risk of delirium at discharge for an elderly patient who develops delirium in the hospital based on the score of Inouye et al.

Description

Specialty

Objective

ICD-10