Assessing delirium in cancer patients. The Italian versions of the Delirium Rating Scale and the Memorial Delirium Assessment Scale

To validate the Italian versions of the Delirium Rating Scale (DRS) and the Memorial Delirium Assessment Scale (MDAS), 105 cancer patients consecutive ly referred for neurological or psychiatric consultation for mental status change were evaluated using the Confusion Assessment Method (CAM), the DRS, the MDAS, and the Mini-Mental State Examination (MMSE). According to the C AM criteria and clinical examination, 66 patients were delirious, and 39 re ceived diagnoses other than delirium. The DRS and the MDAS scores significa ntly distinguished delirious from non-delirious patients. The MDAS and the DRS were mutually correlated. When using the proposed cut-off scores for th e two scales, the MDAS had higher specificity (94 %) but lower sensitivity (68 % than the DRS (sensitivity = 95 %, specificity = 61 % for DRS cut-off 10; sensitivity = 80 %, specificity = 76 %, DRS cut-off 12). The MMSE showe d high sensitivity (96 %) and very low specificity (38 %). Exploratory fact or analysis of the DRS and the MDAS suggested a three-factor and two-factor structure, respectively. Both instruments in their Italian version proved to be useful for the assessment of delirium among cancer patients. Further research is needed to examine the use of the DRS and the MDAS in other clin ical contexts. (C) U.S. Cancer Pain Relief Committee, 2001.