Delirium diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Khurana, M.B.B.S., M.D. [2] ;

Pratik Bahekar, MBBS [3] ; Ahmed Zaghw, M.D. [4]

Diagnostic Criteria

Diagnostic and Statistical Manual (DSM-5) Diagnostic Criteria

1. Diminished focus or concentration and lack of knowledge or perception of the surroundings .

1. Developing in a brief period of time accounting to hours to days, a shift from a baseline which change in severity in it’s course.

1. Also, interference in faculties of cognition like, memory, orientation, visuospatial ability, or language).

1. 1st and 3rd criteria are not a result of any previous, current, or developing neurocognitive disorder and also not related to change in arousal status e.g. coma

1. The manifestation of the disturbances resulting as a physiological sequel of a medical condition, intoxication or withdrawal of substance(s) or medicine(s), or a toxin(s); or is due to multiple etiologies, is explained by the history, physical examination, or laboratory findings.

ICD-10 Diagnostic Criteria

Scoring Systems for the Diagnosis of Delirium in Critically Ill Patients

• Confusion Assessment Method for the ICU (CAM-ICU)

The test should be done on a sufficiently awake patient (RASS score, -3 or more)

The criteria of scoring scale:

• An acute change from mental status at base line or fluctuating mental status during the past 24 hr(must be true to be positive)
• More than 2 errors on a 10­point test of atten tion to voice or pictures (must be true to be positive)

The interpretation of scoring system:

• If the RASS is not 0 and the above two criteria are positive, the patient is delirious
• If the RASS is 0 and the above two criteria are positive, test for disorganized thinking using 4 yes/no questions and a 2­step command; >1 error means the patient is delirious; ≤1 error excludes delirium

• Intensive Care Delirium Screening Checklist (ICDSC)

References

Scoring Systems for the Diagnosis of Delirium in Critically Ill Patients

• Confusion Assessment Method for the ICU (CAM-ICU)

The test should be done on a sufficiently awake patient (RASS score, -3 or more)

The criteria of scoring scale:

• An acute change from mental status at base line or fluctuating mental status during the past 24 hr(must be true to be positive)
• More than 2 errors on a 10­point test of atten tion to voice or pictures (must be true to be positive)

The interpretation of scoring system:

• If the RASS is not 0 and the above two criteria are positive, the patient is delirious
• If the RASS is 0 and the above two criteria are positive, test for disorganized thinking using 4 yes/no questions and a 2­step command; >1 error means the patient is delirious; ≤1 error excludes delirium

• Intensive Care Delirium Screening Checklist (ICDSC)