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Table 1 Variables of the mCAM-ED and the 4AT, listed according to the domains

From: Delirium detection in hospitalized adults: the performance of the 4 'A's Test and the modified Confusion Assessment Method for the Emergency Department. A comparison study

Domains

mCAM-ED

4AT

Alertness

mRASS

-5 (unarousable) to + 4 (combative); alert & calm = 0

observation

alert & calm (0) or clearly abnormal (4)

Cognition

Orientation

MSQ

10 questions

(score: ≥ 3 errors indicate altered cognition)

AMT-4

4 questions

(score: 0 errors = 0; 1 error = 1,

 ≥ 2 errors = 2)

 To place

What is the name of this place?

Place (name of hospital / building)

Where is this located (address)?

 To date

What is today’s date?

What is the month now?

What is the year?

Current year

 Towards oneself

How old are you?

Age

When were you born (month)?

Date of birth

When were you born (year)?

 

 On general information

Who is the president of the United States?

Can you name a previous president?

Disorganized thinking

Comprehension Test

4 questions

(score: ≥ 2 mistakes indicate disorganized thinking)

Will a stone float on water?

Can you use a hammer to pound nails?

Do two pounds of apples weigh more than one?

Are there fish in the sea?

Attention

MBT

MBT

Omissions and time required for the task (score: ≥ 3 points indicate inattention)

until July or further

(score: ≥ 7 months = 0, starts but < 7 months / refuses = 1, untestable = 2)

Acute onset or fluctuation

Observation during the interview and information from third party

In the previous 2 weeks or 24 h (score: yes = 4; no = 0)

  1. 4AT   the 4 'A's Test, mCAM-ED   the modified Confusion Assessment Method for the Emergency Department, mRASS   the Modified Richmond Agitation Sedation Scale, MSQ  the Mental Status Questionnaire, AMT-4  the Abbreviated Mental Test 4, MBT   the Months Backwards Test
  2. According to the mCAM-ED delirium is considered when: (acute onset or fluctuation) and inattention and (disorganized thinking and/or alertness) are present. The 4AT total score is between 0 and 12. A score of ≥ 4 points indicates probable delirium