西班牙版4AT量表(4AT- es)对老年住院患者谵妄筛查的诊断准确性

IF 2.5 4区 医学 Q2 PSYCHIATRY
E. Delgado-Parada , D. Morillo-Cuadrado , J Saiz-Ruiz , A. Cebollada-Gracia , J.L. Ayuso-Mateos , A.J. Cruz-Jentoft
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引用次数: 4

摘要

背景和目的4AT量表是筛查谵妄的敏感工具,无需任何专门的培训即可在临床环境中快速应用。它还没有被翻译、改编和验证以评估西班牙老年人。该研究的目的是:翻译并适应西班牙文化的4AT量表,在非专科医院病房应用时提供该版本(4AT-ES)诊断准确性的证据,并评估存在风险因素时诊断准确性的损失。方法前瞻性样本采用4AT-ES和参考标准进行独立评估。121名住院患者(70岁以上)被要求进行精神病评估。其中50人被诊断为谵妄。没有受过专门培训的护士应用4AT-ES,经验丰富的精神科医生采用参考标准诊断(DSM-V标准)。结果与对照组相比,谵妄患者年龄较大,风险因素较多(既往谵妄发作次数较多,既往痴呆/认知障碍的可能性较高)。4AT-ES具有良好的有效性、敏感性(96%)和特异性(83.1%),曲线下面积为0.918;在具有任何这些风险因素的子样本中,其值没有降低。结论开发了4AT量表的4AT-ES版本。当由未受过专门培训的护理人员应用时,它显示出极好的有效性、敏感性和特异性,即使在有先前风险因素的子样本中也是如此。所有指数都与原始版本相当。我们建议将其用于疑似谵妄的住院老年患者的有效谵妄筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic accuracy of the Spanish version of the 4AT scale (4AT-ES) for delirium screening in older inpatients

Background and objectives

The 4AT scale is a sensitive tool for screening delirium, which can be applied rapidly in clinical settings without any specific training. It has not been translated, adapted, and validated to assess Spanish older adults. The aims of the study are: to translate and adapt to Spanish culture the 4AT scale, to present evidence of the diagnostic accuracy of this version (4AT-ES) when applied in non-specialized hospital wards, and to assess the loss of diagnostic accuracy in presence of risk factors.

Methods

A prospective sample was independently assessed on the 4AT-ES and the reference standard. One hundred and twenty-one inpatients (70+ years) for whom a psychiatric assessment was requested were included. Out of them, 50 were diagnosed with delirium. Nurses without specific training applied the 4AT-ES, and experienced psychiatrists cast the reference standard diagnosis (DSM-V criteria).

Results

Patients with delirium were older and had more risk factors (more previous delirium episodes, a higher likelihood of prior dementia/cognitive impairment) than controls. The 4AT-ES had excellent validity, sensitivity (96%) , and specificity (83.1%). The area under the curve was 0.918; in the subsample with any of those risk factors, its value did not decrease.

Conclusion

The 4AT-ES version of the 4AT scale was developed. When applied by non-specifically trained, nursing staff it showed excellent validity, sensitivity, and specificity, even in a subsample with previous risk factors. All indices were comparable to the original version. We recommend its use for efficient delirium screening in hospitalized older patients with suspected delirium.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
40
审稿时长
43 days
期刊介绍: The European journal of psychiatry is a quarterly publication founded in 1986 and directed by Professor Seva until his death in 2004. It was originally intended to report “the scientific activity of European psychiatrists” and “to bring about a greater degree of communication” among them. However, “since scientific knowledge has no geographical or cultural boundaries, is open to contributions from all over the world”. These principles are maintained in the new stage of the journal, now expanded with the help of an American editor.
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