Aims: To investigate whether assessment of delirium severity at diagnosis using the Delirium Observation Screening Scale (DOS scale) predicts adverse outcomes in hospital and on discharge.
Methods: A prospective cohort study was conducted where the DOS scale was administered to patients within 24-48 hours of delirium diagnosis and adverse outcomes extracted from medical charts. Multiple linear regression analyses were performed to evaluate the correlation between DOS scale scores and adverse outcome measures.
Results: 59 patients were included in the study. There was a moderate correlation between increasing DOS scale scores and duration of delirium (r=0.46, p<0.001), as well as increasing DOS scores and decline in mobility on discharge (r=0.35, p0.007). There was a weak correlation between increasing DOS scores and functional decline as measured by change in Katz Index from admission to discharge (r=-0.27, p=0.04). No statistically significant correlations were found between DOS scores and in-hospital mortality, inpatient complication rates or discharge to higher level of care.
Conclusion: Delirium severity assessment as measured by the DOS scale may be useful in predicting short term morbidity, such as increased duration of delirium, decreased mobility and functional status on discharge compared with admission. Measuring delirium severity at diagnosis may be useful to provide prognostic information to the family members and to set expectations and treatment goals. Further research with larger sample sizes is needed to establish if delirium severity predicts adverse outcome.