A Study of the Psychometric Properties of the “Stanford Proxy Test for Delirium” (S-PTD): A New Screening Tool for the Detection of Delirium

Maldonado, José R.; Sher, Yelizaveta; Benitez-Lopez, Mario Alberto; Savant, Vidushi; Garcia, Renée Bradford; Ament, Andrea; Guzman, Earl De

doi:10.1016/j.psym.2019.11.009

Cited by 22 publications

(12 citation statements)

References 53 publications

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“…7,8 Questionnaire-based instruments, [9][10][11] may not apply to uncooperative inpatients with delirium or disabling symptoms. 12 Research has focused on developing feasible and accurate determinations of frailty in hospitalized patients. Three instruments based on the deficit accumulation model have emerged as potentially practical, accurate, and valid measures of frailty: the Clinical Frailty Scale (CFS), 13 the Hospital Frailty Risk Score (HFRS), 14 and a frailty index based on laboratory values (FI-LAB).…”

Section: Introductionmentioning

confidence: 99%

“…Most acutely ill patients will be unlikely to complete physical tasks, and floor effects may result in the inappropriate categorization of frailty 7,8 . Questionnaire‐based instruments, 9–11 may not apply to uncooperative inpatients with delirium or disabling symptoms 12 . Research has focused on developing feasible and accurate determinations of frailty in hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

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The association of a frailty index from laboratory tests and vital signs with clinical outcomes in hospitalized older adults

Ysea-Hill

Gomez

Mansour

et al. 2022

J American Geriatrics Society

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Background Frailty, a state of vulnerability to stressors resulting from loss of physiological reserve due to multisystemic dysfunction, is common among hospitalized older adults. Hospital clinicians need objective and practical instruments that identify older adults with frailty. The FI‐LAB is based on laboratory values and vital signs and may capture biological changes of frailty that predispose hospitalized older adults to complications. The study's aim was to assess the association of the FI‐LAB versus VA‐FI with hospital and post‐hospital clinical outcomes in older adults. Methods Retrospective cohort study was conducted on Veterans aged ≥60 admitted to a VA hospital. We identified acute hospitalizations January 2011‐December‐2014 with 1‐year follow‐up. A 31‐item FI‐LAB was created from blood laboratory tests and vital signs collected within the first 48 h of admission and scores were categorized as low (<0.25), moderate (0.25–0.40), and high (>0.40). For each FI‐LAB group, we obtained odds ratio (OR) and confidence intervals (CI) for hospital and post‐hospital outcomes using multivariate binomial logistic regression. Additionally, we calculated hazard ratios (HR) and CI for all‐cause in‐hospital mortality comparing the high and moderate FI‐LAB group with the low group. Results Patients were 1407 Veterans, mean age 72.7 (SD = 9.0), 67.8% Caucasian, 96.1% males, 47.0% (n = 661), 41.0% (n = 577), and 12.0% (n = 169) were in the low, moderate, and high FI‐LAB groups, respectively. Moderate and high scores were associated with prolonged LOS, OR:1.62 (95% CI:1.29–2.03); and 3.36 (95% CI:2.27–4.99), ICU admission, OR:1.40 (95% CI:1.03–1.90); and OR:2.00 (95% CI:1.33–3.02), nursing home placement OR:2.36 (95% CI:1.26–4.44); and 5.99 (95% CI:2.83–12.70), 30‐day readmissions OR:1.74 (95% CI:1.20–2.52); and 2.20 (95% CI:1.30–3.74), 30‐day mortality OR: 2.51 (95% CI:1.01–6.23); and 8.97 (95% CI:3.42–23.53), 6‐month mortality OR:3.00 (95% CI:1.90–4.74); and 6.16 (95% CI:3.55–10.71), and 1‐year mortality OR: 2.66 (95% CI:1.87–3.79); and 4.76 (95% CI:3.00–7.54) respectively. The high FI‐LAB group showed higher risk of in‐hospital mortality, HR:18.17 (95% CI:4.01–80.52) with an area‐under‐the‐curve of 0.843 (95% CI:0.75–0.93). Conclusions High and moderate FI‐LAB scores were associated with worse in‐hospital and post‐hospital outcomes. The FI‐LAB may identify hospitalized older patients with frailty at higher risk and assist clinicians in implementing strategies to improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The association of a frailty index from laboratory tests and vital signs with clinical outcomes in hospitalized older adults

Ysea-Hill

Gomez

Mansour

et al. 2022

J American Geriatrics Society

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“…The time-tested Confusion Assessment Method for the ICU[ 70 ] should be followed routinely. Other useful scales are Intensive Care Delirium Screening Checklist[ 71 ] and the Stanford Proxy Test for Delirium. [ 72 ]…”

Section: Neuropsychiatric Symptoms In Covid-19mentioning

confidence: 99%

Covid-19 Ards

Sasidharan

Singh

et al. 2021

Journal of Anaesthesiology Clinical Pharmacology

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Physicians and care providers are familiar with the management of ARDS, however, when it occurs as a sequalae of COVID-19, it has different features and there remains uncertainty on the consensus of management. To answer this question on how it compares and contrasts with ARDS from other causes, the authors reviewed the published literature and management guidelines as well as their own clinical experience while managing patients with COVID-19 ARDS. For research, a PubMed search was conducted on 01.04.2021 using the systematic review filter to identify articles that were published using MeSH terms COVID-19 and ARDS. Systematic reviews or meta-analyses were selected from a systematic search for literature containing diagnostic, prognostic and management strategies in MEDLINE/PubMed. Those were compared and reviewed to the existing practices by the various treating specialists and recommendations were made. Specifically, the COVID-19 ARDS, its risk factors and pathophysiology, lab diagnosis, radiological findings, rational of recommendation of drugs proposed so far, oxygenation and ventilation strategies and the psychological ramifications of the disease were. discussed. Because of the high mortality in mechanically ventilated patients, the above recommendations and findings direct the potential for improvement in the management of patients with COVID-19 ARDS.

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“…The diagnosis of delirium was made according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, based on acute onset of disturbance of attention and awareness, impaired cognition, agitation, and sleep-wake cycle dysregulation in context of medical illness, 8 and confirmed by the Confusion Assessment Method for the ICU 9 and the Stanford Proxy Test for Delirium. 10,11 Given psychiatry's recommendations, melatonin was increased to 15 mg nightly to regulate sleep-wake cycle and for the antioxidant and anti-inflammatory effects, and suvorexant, an orexin antagonist, was added at 20 mg for sleep-wake cycle regulation. Guanfacine, an alpha-2 agonist, was started at 0.5 mg twice daily and titrated to 1 mg thrice daily to reduce sympathetic outflow, manage agitation, and assist in weaning intravenous sedatives.…”

Section: Case Descriptionmentioning

confidence: 99%

“…9 Thus, a novel tool, the Stanford Proxy Test for Delirium, might be particularly helpful as it relies on nursing report of patients' cognition and behaviors, rather than on patient's participation. 10,11 Ms. A was initially evaluated remotely from outside of the room, integrating review of the chart and descriptions of her behavior and mental status from her nursing and medical staff. Confusion Assessment Method for the ICU and Stanford Proxy Test for Delirium were also used in her evaluation and diagnosis.…”

Section: Evaluation and Diagnosismentioning

confidence: 99%

COVID-19–Associated Hyperactive Intensive Care Unit Delirium With Proposed Pathophysiology and Treatment: A Case Report

et al. 2020

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A Study of the Psychometric Properties of the “Stanford Proxy Test for Delirium” (S-PTD): A New Screening Tool for the Detection of Delirium

Cited by 22 publications

References 53 publications

The association of a frailty index from laboratory tests and vital signs with clinical outcomes in hospitalized older adults

The association of a frailty index from laboratory tests and vital signs with clinical outcomes in hospitalized older adults

Covid-19 Ards

COVID-19–Associated Hyperactive Intensive Care Unit Delirium With Proposed Pathophysiology and Treatment: A Case Report

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