Delirium in older adults following traumatic brain injury during the acute stage: Validation of the Chinese version of the confusion assessment method

Abstract

Aim

To translate and validate the confusion assessment method into traditional Chinese (CAM-TC) and explore the incidence of delirium following traumatic brain injury (TBI) in the ward setting.

Background

The CAM is a widely recognized tool for screening delirium, but it has not been translated into Traditional Chinese version, and it has seldom been used to assess delirium in TBI survivors in general wards.

Methods

Patients aged 20 years or older, diagnosed with TBI, and with a Glasgow Coma Scale (GCS) score of 9 or higher at admission were included. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria were employed as the gold standard. Cohen's kappa was used to calculate inter-rater reliability.

Results

Our study enrolled 100 patients with a mean age of 68.5 years and mild TBI. Post-TBI delirium was diagnosed in 10 % of the sample using DSM-5-TR criteria. A subset of 10 patients was selected for inter-rater reliability analysis, and a kappa value of 1.0 was obtained. The sensitivity, specificity, and area under the receiver operating characteristic curve values were 0.90, 0.98, and 0.94, respectively.

Conclusions

The CAM-TC is a reliable tool for screening delirium following TBI in the ward setting. Our findings provide new insights into post-TBI delirium in this environment. Implementing an applicable delirium screening tool for post-TBI patients could facilitate further research on prevention and intervention strategies.