The AWOL tool: Derivation and validation of a delirium prediction rule
The AWOL tool: Derivation and validation of a delirium prediction rule
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DOI：
10.1002/jhm.2062
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发表时间：
2013-09-01
影响因子：
2.6
通讯作者：
Josephson, S. Andrew
中科院分区：
文献类型：
--
作者：
Douglas, Vanja C.;Hessler, Christine S.;Josephson, S. Andrew
背景技术背景：谵妄的危险因素有很好的描述，但没有广泛使用的工具来预测住院患者入院后谵妄的发展。目的：开发和验证一种工具来预测住院期间发生谵妄的可能性。设计：前瞻性队列研究，（2010年5月至2010年11月）和验证地点：两个学术医学中心和一个退伍军人事务部医学中心。连续性内科住院病人（推导组209例，验证组165例），年龄50岁以上，入院时无谵妄。AWOL预测规则是通过对入组时评估的4个项目中的每个项目分配1分得出的，这些项目与谵妄的发生独立相关（> 80岁，无法向后拼写World，位置定向障碍和较高的护士评定的谵妄严重程度）。在推导和验证队列中，较高的分数与较高的谵妄发生率相关（P <0.05）。
BACKGROUND: Risk factors for delirium are well-described, yet there is no widely used tool to predict the development of delirium upon admission in hospitalized medical patients.OBJECTIVE: To develop and validate a tool to predict the likelihood of developing delirium during hospitalization.DESIGN: Prospective cohort study with derivation (May 2010-November 2010) and validation (October 2011-March 2012) cohorts.SETTING: Two academic medical centers and 1 Veterans Affairs medical center.PATIENTS: Consecutive medical inpatients (209 in the derivation and 165 in the validation cohort) over age 50 years without delirium at the time of admission.MEASUREMENTS: Delirium assessed daily for up to 6 days using the Confusion Assessment Method.RESULTS: The AWOL prediction rule was derived by assigning 1 point to each of 4 items assessed upon enrollment that were independently associated with the development of delirium (Age80 years, failure to spell World backward, disOrientation to place, and higher nurse-rated iLlness severity). Higher scores were associated with higher rates of delirium in the derivation and validation cohorts (P for trend