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      Validity and reliability of the Portuguese version of the Confusion Assessment Method (CAM) for the detection of delirium in the elderly Translated title: Validação e confiabilidade da versão em língua portuguesa do confusion assessment method (CAM) para a detecção de delirium no idoso

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          Abstract

          This study has tested the validity and reliability of the Portuguese version of the Confusion Assessment Method (CAM), a diagnostic assessment instrument for delirium developed by Inouye et al. (1990). The sample was formed by 100 patients with 60 and more years of age, admitted at the emergency service of Santa Casa de São Paulo, in the time periods between July and August, 1996, November and December, 1996 and February and March, 1997. The sensibility was 94.1% and specificity 96.4%. The assessors reliability in a sample of the 24 patients resulted in a kappa = 0.70. We have concluded that CAM is an adequate instrument to assess the presence of delirium, reliable to assess elderly patients at the emergency services.

          Translated abstract

          O presente estudo testou a validade e confiabilidade da versão em língua portuguesa do Confusion Assessment Method (CAM), instrumento de avaliação diagnóstica de delirium desenvolvido por Inouye e col. (1990). A amostra foi composta de 100 pacientes com idade igual ou superior a 60 anos atendidos no serviço de urgência da Santa Casa de São Paulo nos períodos de julho a agosto de 1996, novembro a dezembro de 1996 e fevereiro a março de 1997. Os resultados apontaram sensibilidade de 94,1% e especificidade de 96,4%. Confiabilidade entre avaliadores em subgrupos de 24 pacientes produziu kappa = 0,70. Concluimos que o CAM é um instrumento que afere a presença de delirium de forma adequada e que pode ser utilizado de forma confiável na avaliação de pacientes idosos atendidos em serviços de urgência.

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          Most cited references37

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          Diagnostic and statistical manual of mental disorders.

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            Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde

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              The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients.

              Delirium, with occurrence rates from 14% to 56%, associated mortality rates from 10% to 65%, and excess annual health care expenditures from $1 to $2 billion, poses a common and serious problem for hospitalized elderly patients. Delirium is often unrecognized or misdiagnosed by physicians caring for elderly patients. Cognitive testing is rarely done as part of the admission evaluation of elderly hospitalized patients. Specific diagnosis has been difficult, since diagnostic criteria and instruments are still being developed. The etiology of delirium is complex and multifactorial, and both predisposing (host vulnerability) and precipitating factors must be considered. The recommended approach to the evaluation of delirium is empiric, in the absence of objective efficacy data. The cornerstone of evaluation includes a careful history, physical examination, and review of the medication list--since medications are the most common reversible cause of delirium. Research is needed to establish a cost-effective approach and to clarify the role of further testing, such as cerebrospinal fluid examination, brain imaging, and electroencephalography. This article is intended to heighten the awareness of clinicians as well as to stimulate research to address this important, neglected problem for elderly hospitalized patients.

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                June 2001
                : 59
                : 2A
                : 175-179
                Affiliations
                [1 ] Santa Casa Medical School Brazil
                [2 ] Santa Casa Medical School
                [3 ] Santa Casa Medical School
                [4 ] Queen Elisabeth II Medical Centre Australia
                Article
                S0004-282X2001000200004
                10.1590/S0004-282X2001000200004
                11400020
                dd700b4d-55db-4e55-abbb-2dc8e9ec2b22

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                delirium,elderly,emergency service,validity,CAM,idoso,serviço de urgência,validação

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