The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium
Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale–Revised–98 (DRS). Data were collected as part of an ongoi...
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| Published in | BJA open Vol. 14; p. 100398 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier Ltd
01.06.2025
Elsevier |
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| Online Access | Get full text |
| ISSN | 2772-6096 2772-6096 |
| DOI | 10.1016/j.bjao.2025.100398 |
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| Abstract | Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale–Revised–98 (DRS).
Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis.
Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P<0.001) and short form method (ρ=0.66, P<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P<0.001 and ρ=0.91, P<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P<0.001, n=177), slow-wave electroencephalogram power (ρ=0.3, P=0.001, n=73), and plasma neurofilament light (ρ=0.26, P<0.05, n=61) and tau (ρ=0.41, P<0.001, n=63).
The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population.
NCT03124303. |
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| AbstractList | Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale-Revised-98 (DRS).
Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis.
Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74,
<0.001) and short form method (ρ=0.66,
<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71,
<0.001 and ρ=0.91,
<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37,
<0.001,
=177), slow-wave electroencephalogram power (ρ=0.3,
=0.001,
=73), and plasma neurofilament light (ρ=0.26,
<0.05,
=61) and tau (ρ=0.41,
<0.001,
=63).
The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population.
NCT03124303. Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale–Revised–98 (DRS). Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis. Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P<0.001) and short form method (ρ=0.66, P<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P<0.001 and ρ=0.91, P<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P<0.001, n=177), slow-wave electroencephalogram power (ρ=0.3, P=0.001, n=73), and plasma neurofilament light (ρ=0.26, P<0.05, n=61) and tau (ρ=0.41, P<0.001, n=63). The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population. NCT03124303. Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale-Revised-98 (DRS).BackgroundSeveral methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale-Revised-98 (DRS).Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis.MethodsData were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis.Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P<0.001) and short form method (ρ=0.66, P<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P<0.001 and ρ=0.91, P<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P<0.001, n=177), slow-wave electroencephalogram power (ρ=0.3, P=0.001, n=73), and plasma neurofilament light (ρ=0.26, P<0.05, n=61) and tau (ρ=0.41, P<0.001, n=63).ResultsOf 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P<0.001) and short form method (ρ=0.66, P<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P<0.001 and ρ=0.91, P<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P<0.001, n=177), slow-wave electroencephalogram power (ρ=0.3, P=0.001, n=73), and plasma neurofilament light (ρ=0.26, P<0.05, n=61) and tau (ρ=0.41, P<0.001, n=63).The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population.ConclusionsThe 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population.NCT03124303.Clinical trial registrationNCT03124303. Background: Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale–Revised–98 (DRS). Methods: Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis. Results: Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P<0.001) and short form method (ρ=0.66, P<0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P<0.001 and ρ=0.91, P<0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P<0.001, n=177), slow-wave electroencephalogram power (ρ=0.3, P=0.001, n=73), and plasma neurofilament light (ρ=0.26, P<0.05, n=61) and tau (ρ=0.41, P<0.001, n=63). Conclusions: The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population. Clinical trial registration: NCT03124303. |
| ArticleNumber | 100398 |
| Author | Kunkel, David Pearce, Robert A. Lennertz, Richard Rivera, Cameron Sanders, Robert D. Her, Maihlee Qureshi, Simran |
| Author_xml | – sequence: 1 givenname: Cameron orcidid: 0009-0002-5265-9002 surname: Rivera fullname: Rivera, Cameron organization: Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA – sequence: 2 givenname: David orcidid: 0000-0003-1812-8312 surname: Kunkel fullname: Kunkel, David organization: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA – sequence: 3 givenname: Maihlee surname: Her fullname: Her, Maihlee organization: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA – sequence: 4 givenname: Simran surname: Qureshi fullname: Qureshi, Simran organization: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA – sequence: 5 givenname: Robert A. orcidid: 0000-0002-1516-6260 surname: Pearce fullname: Pearce, Robert A. organization: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA – sequence: 6 givenname: Robert D. surname: Sanders fullname: Sanders, Robert D. organization: University of Sydney, Sydney, NSW, Australia – sequence: 7 givenname: Richard orcidid: 0000-0003-3273-9056 surname: Lennertz fullname: Lennertz, Richard email: rlennertz@wisc.edu organization: Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA |
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| Title | The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium |
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