Instrumentos para el diagnóstico de delirium en hispanohablantes: artículo de revisión
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Resumen
El delirium es un síndrome potencialmente tratable, de presentación aguda con secuelas crónicas sobre la morbimortalidad de quienes lo sufren. Frecuentemente, se pasa por alto y, para subsanar esta situación, en principio es indispensable que todo el personal de salud sea consciente de la importancia del trastorno en su trabajo diario y, en segundo lugar, es necesario conocer las herramientas útiles para su evaluación, tanto por parte de los especialistas en neurociencias como por el personal tratante de las diversas áreas de la medicina. En este artículo se presenta información práctica sobre las características de los instrumentos para evaluar el delirium en diversos escenarios, con énfasis en los disponibles en español. Se describen algunos aspectos de validez y confiabilidad relevantes y se presenta una tabla con el resumen cualitativo de los datos más significativos para las diversas escalas descritas. El uso habitual de estas herramientas redundaría en una mejor atención de los pacientes y será el punto de partida para generar información que permita mejorar la calidad de los instrumentos o plantear la necesidad de validar o crear otros en países iberoamericanos.
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Trzepacz PT, Meagher DJ. Neuropsychiatric aspects of delirium. In: The American Psychiatric Publishing textbook of neuropsychiatry and behavioral neurosciences. 5th ed. Arlington: American Psychiatric Publishing; 2008. p. 445–518.
Grover S. Assessment scales for delirium: A review. World J Psychiatry 2012; 2(4):58-70.
Marcantonio ER, Kiely DK, Simon SE, John Orav E, Jones RN, Murphy KM, et al. Outcomes of older people admitted to postacute facilities with delirium. J Am Geriatr Soc 2005; 53(6):963–969.
Marcantonio E, Ta T, Duthie E, Resnick NM. Delirium severity and psychomotor types: their relationship with outcomes after hip fracture repair. J Am Geriatr Soc 2002; 50(5):850–857.
Vásquez JGF, Parra AG, Álvarez DL. Delirium asociado a hospitalización prolongada en pacientes de medicina interna en la Clínica Universitaria Bolivariana. Med U.P.B. 2001; 20(1):29–36.
Cole M, McCusker J, Dendukuri N, Han L. The prognostic significance of subsyndromal delirium in elderly medical inpatients. J Am Geriatr Soc 2003; 51(6):754–760.
Bourdel-Marchasson I, Vincent S, Germain C, Salles N, Jenn J, Rasoamanarivo E, et al. Delirium symptoms and low dietary intake in older inpatients are independent predictors of institutionalization: a 1-year prospective population-based study. J Gerontol A Biol Sci Med Sci 2004; 59(4):350–354.
Cole MG, McCusker J, Ciampi A, Belzile E. The 6- and 12-month outcomes of older medical inpatients who recover from subsyndromal delirium. J Am Geriatr Soc 2008; 56(11):2093–2099.
Martinez VN, Franco JG. [Subsyndromal delirium in elderly patients: a systematic review]. Rev Esp Geriatr Gerontol 2013; 48(3): 122–129. DOI: 10.1016/j.regg.2012.11.007.
Trzepacz PT. Is there a final common neural pathway in delirium? Focus on acetylcholine and dopamine. Semin Clin Neuropsychiatry 2000;5(2):132–148.
Franco JG, Trzepacz PT, Meagher DJ, Kean J, Lee Y, Kim J-L, et al. Three core domains of delirium validated using exploratory and confirmatory factor analyses. Psychosomatics 2013; 54(3):227–238.
González M, de Pablo J, Fuente E, Valdés M, Peri JM, Nomdedeu M, et al. Instrument for detection of delirium in general hospitals: adaptation of the Confusion Assessment Method. Psychosomatics 2004; 45(5):426–431.
Meagher D, Adamis D, Leonard M, Trzepacz P, Grover S, Jabbar F, et al. Development of an abbreviated version of the delirium motor subtyping scale (DMSS-4). Int Psychogeriatrics 2014; 26(4):693–702.
Franco JG, Gómez PE, Ocampo MV, Vargas A, Berríos DM. Prevalencia de trastornos psiquiátricos en pacientes medicoquirúrgicos hospitalizados en la Clínica Universitaria Bolivariana de Medellín, Colombia. Colomb Med 2005; 36(3):186–193.
Salluh JI, Soares M, Teles JM, Ceraso D, Raimondi N, Nava VS, et al. Delirium epidemiology in critical care (DECCA): an international study. Crit Care 2010; 14(6):R210.
Johnson JC, Kerse NM, Gottlieb G, Wanich C, Sullivan E, Chen K. Prospective versus retrospective methods of identifying patients with delirium. J Am Geriatr Soc 1992; 40(4):316–319.
Sepulveda E, Franco JG, Trzepacz PT, Gaviria AM, Viñuelas E, Palma J, et al. Performance of the Delirium Rating Scale-Revised-98 against different delirium diagnostic criteria in a population with a high prevalence of dementia. Psychosomatics 2015; 56(5):530–541.
Cole MG, Dendukuri N, McCusker J, Han L. An empirical study of different diagnostic criteria for delirium among elderly medical inpatients. J Neuropsychiatry Clin Neurosci 2003; 15(2):200–207.
Laurila JV, Pitkala KH, Strandberg TE, Tilvis RS. Delirium among patients with and without dementia: does the diagnosis according to the DSM-IV differ from the previous classifications? Int J Geriatr Psychiatry 2004; 19(3):271–277.
Reed GM, Ayuso-Mateos JL. Towards a more clinically useful International World Health Organisation classification of mental disorders. Rev Psiquiatr y Salud Ment 2011; 4(3):113–116.
Tohen M. Psychiatric collaborations in the Hispanic world. Rev Psiquiatr y Salud Ment 2014; 7(4):155–156.
Sepulveda E, Franco JG. Delirium in the Spanish version of the DSM-5: More confusion? Rev Psiquiatr Salud Ment 2015; 8(4):242–243 DOI: 10.1016/j.rpsm.2015.05.002.
Trzepacz PT, Mulsant BH, Dew MA, Pasternak R, Sweet RA, Zubenko GS. Is delirium different when it occurs in dementia? A study using the delirium rating scale. J Neuropsychiatry Clin Neurosci 1998; 10(2):199–204.
Cole MG, McCusker J, Dendukuri N, Han L. Symptoms of delirium among elderly medical inpatients with or without dementia. J Neuropsychiatry Clin Neurosci 2002; 14(2):167–175.
Voyer P, Cole MG, McCusker J, Belzile E. Prevalence and symptoms of delirium superimposed on dementia. Clin Nurs Res 2006; 15(1):46–66.
Edlund A, Lundström M, Sandberg O, Bucht G, Brännström B, Gustafson Y. Symptom profile of delirium in older people with and without dementia. J Geriatr Psychiatry Neurol 2007; 20(3):166–171.
Meagher DJ, Leonard M, Donnelly S, Conroy M, Saunders J, Trzepacz PT. A comparison of neuropsychiatric and cognitive profiles in delirium, dementia, comorbid delirium-dementia and cognitively intact controls. J Neurol Neurosurg Psychiatry 2010; 81(8):876–881.
Trzepacz PT, Maldonado JR, Kean J, Abell M, Meagher DJ. Delirium Rating Scale-Revised-98 (DRS-R98). Manual de administración. Version en español. [Internet]. Edición el. 2010.
Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med 2002; 166(10):1338–1344.
Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 2001; 286(21):2703–2710.
Smith HAB, Boyd J, Fuchs DC, Melvin K, Berry P, Shintani A, et al. Diagnosing delirium in critically ill children: Validity and reliability of the Pediatric Confusion Assessment Method for the Intensive Care Unit. Crit Care Med 2011; 39(1):150–157.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3):189–198.
Rosselli D, Ardila A, Pradilla G, Morillo L, Bautista L, Rey O, et al. [The Mini-Mental State Examination as a selected diagnostic test for dementia: a Colombian population study. GENECO]. Rev Neurol 2000; 30(5):428–432.
Franco JG, Santesteban O, Trzepacz P, Bernal C, Valencia C, Ocampo MV, et al. MMSE items that predict incident delirium and hypoactive subtype in older medical inpatients. Psychiatry Res 2014; 220(3):975–981.
Trzepacz PT, Hochstetler H, Wang S, Walker B, Saykin AJ. Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults. BMC Geriatr 2015; 15:107.
Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. [Revalidation and standardization of the cognition mini-exam (first Spanish version of the Mini-Mental Status Examination) in the general geriatric population]. Med Clínica 1999; 112(20):767–774.
Xu Q, Cao W, Mi J, Yu L, Lin Y, Li Y. Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-Mental State Examination. Eur Neurol 2014; 71(3-4):106–114.
Biundo R, Weis L, Bostantjopoulou S, Stefanova E, Falup-Pecurariu C, Kramberger MG, et al. MMSE and MoCA in Parkinson’s disease and dementia with Lewy bodies: a multicenter 1-year follow-up study. J Neural Transm [Internet]. 2016 [cited 2016 Feb 11]; Available from: http:// www.ncbi.nlm.nih.gov/pubmed/26852137
Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: The Confusion Assessment Method. A new method for detection of delirium. Ann Intern Med 1990; 113(12):941–948.
Toro AC, Escobar LM, Franco JG, Díaz-Gómez JL, Muñoz JF, Molina F, et al. [Spanish version of the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit). Pilot study of validation]. Med Intensiva 2010; 34(1):14–21. DOI: 10.1016/j.medin.2009.07.002.
Meagher DJ, Morandi A, Inouye SK, Ely W, Adamis D, Maclullich AJ, et al. Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98. BMC Med 2014; 12(1):164.
Adamis D, Rooney S, Meagher D, Mulligan O, McCarthy G. A comparison of delirium diagnosis in elderly medical inpatients using the CAM, DRS-R98, DSM-IV and DSM-5 criteria. Int Psychogeriatrics 2015; 27(6):883–889.
Tobara E, Galleguillos T, Fuentes P, Cornejo R, Bo F, Bugedo G, et al. Método para la evaluación de la confusión en la unidad de cuidados intensivos para el diagnostico de delirium: adaptación cultural y validación de la versión en idioma espanol. Med Intensiva 2010; 34(1):4–13.
Franco JG, Ricardo C, Muñoz JF, de Pablo J, Berry P, Ely EW, et al. Diagnosing delirium in critically ill children: Spanish translation and cultural adaptation of the Pediatric Confusion Assessment Method for the Intensive Care Unit. Crit Care Med 2012; 40(3):1034.
Gaudreau J-D, Gagnon P, Harel F, Tremblay A, Roy M-A. Fast, Systematic, and Continuous Delirium Assessment in Hospitalized Patients: The Nursing Delirium Screening Scale. J Pain Symptom Manage. 2005; 29(4):368–375.
Hart RP, Levenson JL, Sessler CN, Best AM, Schwartz SM, Rutherford LE. Validation of a cognitive test for delirium in medical ICU patients. Psychosomatics 1996; 37(6):533–546.
González C, Páez F, Vázquez F, Ocampo J. Evaluación de la validez y confiabilidad de la Escala Cognoscitiva para el Delirium. Salud Ment 2000; 23(5):20–25.
Beglinger LJ, Mills JA, Vik SM, Duff K, Denburg NL, Weckmann MT, et al. The neuropsychological course of acute delirium in adult hematopoietic stem cell transplantation patients. Arch Clin Neuropsychol 2011; 26(2):98–109.
Inouye SK, Westendorp RGJ, Saczynski JS. Delirium in elderly people. Lancet. 2014; 383(9920):911–922.
Adamis D, Meagher D, O’Neill D, McCarthy G. The utility of the clock drawing test in detection of delirium in elderly hospitalised patients. Aging Ment Health 2016; 20(9):981-986.
Lees R, Corbet S, Johnston C, Moffitt E, Shaw G, Quinn TJ. Test accuracy of short screening tests for diagnosis of delirium or cognitive impairment in an acute stroke unit setting. Stroke. 2013; 44(11):3078–3083.
Tieges Z, Brown LJE, MacLullich AMJ. Objective assessment of attention in delirium: a narrative review. Int J Geriatr Psychiatry 2014; 29(12):1185–1197.
Breitbart W, Rosenfeld B, Roth A, Smith MJ, Cohen K, Passik S. The Memorial Delirium Assessment Scale. J Pain Symptom Manage 1997; 13(3):128–137.
Meagher DJ, Moran M, Raju B, Gibbons D, Donnelly S, Saunders J, et al. Phenomenology of delirium. Assessment of 100 adult cases using standardised measures. Br J Psychiatry 2007; 190:135–141.
Franco JG, Trzepacz PT, Mejía MA, Ochoa SB. Factor analysis of the Colombian translation of the Delirium Rating Scale (DRS), Revised-98. Psychosomatics 2009; 50(3):255–262.
Trzepacz PT, Franco JG, Meagher DJ, Lee Y, Kim J-L, Kishi Y, et al. Phenotype of subsyndromal delirium using pooled multicultural Delirium Rating Scale--Revised-98 data. J Psychosom Res 2012; 73(1):10–17.
Thurber S, Kishi Y, Trzepacz PT, Franco JG, Meagher DJ, Lee Y, et al. Confirmatory Factor Analysis of the Delirium Rating Scale Revised-98 (DRS-R98). J Neuropsychiatry Clin Neurosci 2015; 27(2):e122–127.
Noguera A, Carvajal A, Alonso-Babarro A, Chisholm G, Bruera E, Centeno C. First Spanish version of the Memorial Delirium Assessment Scale: psychometric properties, responsiveness, and factor loadings. J Pain Symptom Manage 2014; 47(1):189–197.
Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res 1988; 23(1):89–97.
Trzepacz PT, Dew MA. Further analyses of the Delirium Rating Scale. Gen Hosp Psychiatry 1995; 17(2):75–79.
Secín Diep R, Esponda J, Rivera Meza B, Pujol G, Rodríguez S, Sepúlveda Amor J. Validación del Delirium Rating Scale (DRS) en español en una unidad de cuidados intensivos. Psiquis (Mexico) 1998; 7(1):7–14.
Bulbena A. Escalas en delirium y orientación. Adaptación castellana del Delirium Rating Scale y de la orientation scale. Revista Multidisciplinar de Gerontología 1996;245–253.
Fonseca F, Bulbena A, Navarrete R, Aragay N, Capo M, Lobo A, et al. Spanish version of the Delirium Rating Scale-Revised-98: reliability and validity. J Psychosom Res 2005; 59(3):147–151.
Franco JG, Mejía MA, Ochoa SB, Ramírez LF, Bulbena A, Trzepacz P. [Delirium rating scalerevised-98 (DRS-R-98): Colombian adaptation of the Spanish version]. Actas Esp Psiquiatr 2007; 35(3):170–175.
Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the Delirium Rating Scale-revised-98: Comparison with the delirium rating scale and the cognitive test for delirium. J Neuropsychiatry Clin Neurosci 2001; 13(2):229–242.
De Negreiros DP, da Silva Meleiro AMA, Furlanetto LM, Trzepacz PT. Portuguese version of the Delirium Rating Scale-Revised-98: reliability and validity. Int J Geriatr Psychiatry 2008; 23(5):472–477.
Huang M-C, Lee C-H, Lai Y-C, Kao Y-F, Lin H-Y, Chen C-H. Chinese version of the Delirium Rating Scale-Revised-98: reliability and validity. Compr Psychiatry 2009; 50(1):81–85.
Kato M, Kishi Y, Okuyama T, Trzepacz PT, Hosaka T. Japanese version of the Delirium Rating Scale, Revised-98 (DRS-R98-J): reliability and validity. Psychosomatics 2010; 51(5):425–431.
Lee Y, Ryu J, Lee J, Kim H-J, Shin IH, Kim J-L, et al. Korean version of the delirium rating scalerevised-98: reliability and validity. Psychiatry Investig 2011; 8(1):30–38.
Sepulveda E, Franco JG, Trzepacz PT, Gaviria AM, Viñuelas E, Palma J, et al. Performance of the Delirium Rating Scale-Revised-98 against different delirium diagnostic criteria in a population with a high prevalence of dementia. Psychosomatics 2015; 56(5):530-541.
Trzepacz PT, Meagher DJ, Franco JG. Comparison of diagnostic classification systems for delirium with new research criteria that incorporate the three core domains. J Psychosom Res 2016; 84:60-68.
Leonard M, Godfrey A, Silberhorn M, Conroy M, Donnelly S, Meagher D, et al. Motion analysis in delirium: a novel method of clarifying motoric subtypes. Neurocase. 2007; 13(4):272–277.
Godfrey A, Conway R, Leonard M, Meagher D, Olaighin GM. A continuous wavelet transform and classification method for delirium motoric subtyping. IEEE Trans Neural Syst Rehabil Eng 2009; 17(3):298–307.
Godfrey A, Leonard M, Donnelly S, Conroy M, Olaighin G, Meagher D. Validating a new clinical subtyping scheme for delirium with electronic motion analysis. Psychiatry Res 2010; 178(1):186–190.