Performance of the French version of the 4AT for screening the elderly for delirium in the emergency department

CJEM
Anne-Julie GagnéMarcel Émond

Abstract

Delirium is very frequent in older patients presenting to the emergency department (ED), but is often undetected. The purpose of this study was to evaluate the performance of the French version of the 4 A’s Test (4AT-F) for the detection of delirium and cognitive impairment in older patients. The study was conducted in four Canadian ED. Participants (n= 320) were independent or semi-independent patients (able to perform ≥5 activities of daily living) aged 65 and older and had an 8-hour exposure to the ED environment. The Telephone Interview for Cognitive Status (TICS-m), the Confusion Assessment Method (CAM) as well as the 4AT-F were administered to patients at the initial interview. The CAM and 4AT-F were then administered twice a day during the patients’ ED or hospital stay. The 4AT-F’s sensitivity and specificity were compared to those of the CAM (for delirium), and to that of the TICS (for cognitive impairment). Our results suggest that the 4AT-F has a sensitivity of 84% (95% CI: [76, 93]) and a specificity of 74% (95% CI: [70, 78]) for delirium, as well as a sensitivity of 49% (95% CI: [34, 64]) and a specificity of 87% (95% CI: [82, 92]) for cognitive impairment. The 4AT-F is a fast and reliable screening tool for deliriu...Continue Reading

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Citations

Nov 30, 2018·CJEM·Debra Eagles
Oct 21, 2020·International Journal of Environmental Research and Public Health·Eunhye JeongJuneyoung Lee
Nov 3, 2020·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterUNKNOWN GEAR Network
Dec 29, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Thang S HanChristopher H Fry
Feb 23, 2021·Annals of Emergency Medicine·Rachel E BridwellBrit Long
Apr 18, 2021·Emergency Medicine Clinics of North America·Phillip D Magidson, Christopher R Carpenter
Jun 17, 2021·Philosophy, Ethics, and Humanities in Medicine : PEHM·Guillaume SaccoCédric Annweiler
Jul 11, 2021·The Journal of Thoracic and Cardiovascular Surgery·Yue ChangRakesh C Arora

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