Family identification of delirium in the emergency department in patients with and without dementia : validity of the family confusion assessment method (FAM-CAM)
dc.contributor.author | Mailhot, Tanya | |
dc.contributor.author | Darling, Chad | |
dc.contributor.author | Ela, Jillian | |
dc.contributor.author | Malyuta, Yelena | |
dc.contributor.author | Inouye, Sharon K. | |
dc.contributor.author | Saczynski, Jane | |
dc.date.accessioned | 2023-09-11T12:09:59Z | |
dc.date.available | NO_RESTRICTION | fr |
dc.date.available | 2023-09-11T12:09:59Z | |
dc.date.issued | 2020-04-10 | |
dc.identifier.uri | http://hdl.handle.net/1866/28647 | |
dc.publisher | Wiley | fr |
dc.subject | Delirium | fr |
dc.subject | Dementia | fr |
dc.subject | Emergency department | fr |
dc.subject | FAM-CAM | fr |
dc.subject | Family caregivers | fr |
dc.title | Family identification of delirium in the emergency department in patients with and without dementia : validity of the family confusion assessment method (FAM-CAM) | fr |
dc.type | Article | fr |
dc.contributor.affiliation | Université de Montréal. Faculté des sciences infirmières | fr |
dc.identifier.doi | 10.1111/jgs.16438 | |
dcterms.abstract | OBJECTIVE To examine the ability of the family-rated Family Confusion Assessment Method (FAM-CAM) to identify delirium in the emergency department (ED) among patients with and without dementia, as compared to the reference-standard Confusion Assessment Method (CAM). DESIGN Validation study. SETTING Urban academic ED. PARTICIPANTS Dyads of ED patients, aged 70 years and older, and their family caregivers (N = 108 dyads). MEASUREMENTS A trained reference standard interviewer performed a cognitive screen, delirium symptom assessment, and scored the CAM. The caregiver self-administered the FAM-CAM. Dementia was assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the medical record. For concurrent validity, performance of the FAM-CAM was compared to the CAM. For predictive validity, clinical outcomes (ED visits, hospitalization, and mortality) over 6 months were compared in FAM-CAM positive and negative patients, controlling for age, sex, comorbidity, and cognitive status. RESULTS Among the 108 patients, 30 (28%) were CAM positive for delirium and 58 (54%) presented with dementia. The FAM-CAM had a specificity of 83% and a negative predictive value of 83%. Most false negatives (n = 9 of 13, 69%) were due to caregivers not identifying the inattention criteria for delirium on the FAM-CAM. In patients with dementia, sensitivity was higher than in patients without (61% vs 43%). In adjusted models, a hospitalization in the following 6 months was more than three times as likely in FAM-CAM positive compared to negative patients (odds ratio = 3.4; 95% confidence interval = 1.2-9.3). CONCLUSIONS Among patients with and without dementia, the FAM-CAM shows qualities that are important in the ED setting for identification of delirium. Using the FAM-CAM as part of a systematic screening strategy for the ED, in which familiesʼ assessments could supplement healthcare professionalsʼ assessments, is promising. | fr |
dcterms.isPartOf | urn:ISSN:0002-8614 | fr |
dcterms.isPartOf | urn:ISSN:1532-5415 | fr |
dcterms.language | eng | fr |
UdeM.ReferenceFournieParDeposant | doi: 10.1111/jgs.16438 | fr |
UdeM.VersionRioxx | Version acceptée / Accepted Manuscript | fr |
oaire.citationTitle | Journal of the American geriatrics society | fr |
oaire.citationVolume | 68 | fr |
oaire.citationIssue | 5 | fr |
oaire.citationStartPage | 983 | fr |
oaire.citationEndPage | 990 | fr |
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