Clinical trial NCT02782143: Testing the Validity of the "Modified Confusion Assessment Method for the Emergency Department" (mCAM-ED)"
Official title: Testing the Validity of the "Modified Confusion Assessment Method for the Emergency Department" (mCAM-ED)" for the Recognition of Delirium in Elderly Patient Admitted to the Emergency Department
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Delirium
Keywords: delirium detection
Lead sponsor: University Hospital, Basel, Switzerland
Sponsor class: OTHER
First posted: 2016-05-25
Enrollment: 289
Sex: ALL
Minimum age (years): 65
Maximum age (years): 115
Standard ages: OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients admitted to the emergency department being 65 years and over

Brief summary: The proposed Study validates the accuracy of the modified Confusion Assessment Method for the Emergency Department

Detailed description: Delirium is a complex neuropsychiatric syndrome with sudden change in cognition such as disturbance in orientation or memory particularly in elderly patients in the context of acute illness. Multiple complications such as falls or increased duration of hospitalisation may result in delirium. Long-term consequences may result in increased mortality rates and higher admissions rates to nursing homes. In 2012, delirium prevalence in the Emergency Department (ED) of the University Hospital Basel was 9.5% in patients with 65 years and over. Although a systematic delirium management was introduced in 2012, without systematic screening delirium detection rates varies between 20 and 40% only. The risk of non-detection over the complete hospitalisation is high when early delirium detection did not occur in the ED. In a preliminary evaluation we could show the usefulness of the mCAM-ED

Eligibility criteria: Inclusion Criteria:

* Age \>= 65 years

Exclusion Criteria:

* patients under resuscitation or fatal illness
* not speaking German
* being aphasic
* being deaf

Primary outcomes:
measure: Delirium measured by geriatricians using Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria
timeFrame: once during the stay at the emergency department which lasts an average of 24 hours
measure: Delirium measured by geriatricians using DSM-5 criteria
timeFrame: once during the stay at the emergency department which lasts an average of 24 hours
measure: Delirium measured by advanced practice nurses using the mCAM-ED
timeFrame: once during the stay at the emergency department which lasts an average of 24 hours
measure: degree of concordance between nurses' delirium measurement versus geriatricians' delirium measurement assessed in a four field matrix
timeFrame: once during the stay at the emergency department which lasts an average of 24 hours
Secondary outcomes:
Other outcomes:
Locations:
city: Basel
country: Switzerland
facility: University Hospital Basel
Study officials:
affiliation: usb
name: Wolfgang Hasemann, PhD
role: STUDY_CHAIR
References:
citation: Trzepacz, P. T., & Meagher, D. J. (2008). Neuropsychiatric Aspects of Delirium. In S. C. Yudofsky & R. E. Hales (Eds.), Neuropsychiatry and Behavioral Neurosciences (5 ed., pp. 445-518). Washington, DC: American Psychiatric Publishing, Inc.
citation: Han JH, Zimmerman EE, Cutler N, Schnelle J, Morandi A, Dittus RS, Storrow AB, Ely EW. Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Acad Emerg Med. 2009 Mar;16(3):193-200. doi: 10.1111/j.1553-2712.2008.00339.x. Epub 2009 Jan 20.
citation: Ryan DJ, O'Regan NA, Caoimh RO, Clare J, O'Connor M, Leonard M, McFarland J, Tighe S, O'Sullivan K, Trzepacz PT, Meagher D, Timmons S. Delirium in an adult acute hospital population: predictors, prevalence and detection. BMJ Open. 2013 Jan 7;3(1):e001772. doi: 10.1136/bmjopen-2012-001772.