From Pediatrics to Geriatrics: Toward a Unified Standardized Screening Tool for Delirium: A Thought Experiment.

Abstract

We aim to provide evidence for our view that a single, standardized (and preferably observational) screening tool for delirium should be used in patients of all ages (children, adults, and the elderly). To support our viewpoint, we searched, in the period February 25, 2015, to August 5, 2015, Pubmed and all the major textbooks. We searched PubMed using the following terms: "delirium," "screening tool," "pediatric," "adult," "elderly," "unifying," "observational," "CAPD," and "DOS." We used these terms in various combinations. Abstracts were reviewed for relevance and applicability. Studies were selected by discussion between the two authors. After a comprehensive literature review, conclusions were drawn based on the strength of evidence and the most current understanding of delirium screening practices. The proposed screening tools (Cornell Assessment of Pediatric Delirium and Delirium Observation Screening) entail all main diagnostic criteria, and so they are conceptually valid translations of delirium into operational terms. Given the much greater overlap than difference in this neuropsychiatric context of critical illness between children on the one hand and adults and elderly on the other, we propose that these tools would be ideal as the unified standardized screening tool.