ArticleGerontology2019
The Better Assessment of Illness Study for Delirium Severity: Study Design, Procedures, and Cohort Description.
Article in Gerontology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 12 citations in OpenAlex.
- Assessing Delirium Severity in Dementia: Item Development and Psychometric Validation for a Delirium Severity Instrument.Journal of gerontological nursing · 2024Article
- One-year Medicare costs associated with delirium in older hospitalized patients with and without Alzheimer's disease dementia and related disorders.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Domains of delirium severity in Alzheimer's disease and related dementias.Journal of the American Geriatrics Society · 2022Article
- Harmonization of Four Delirium Instruments: Creating Crosswalks and the Delirium Item-Bank (DEL-IB).The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2022Article
- Psychometric Properties of a Delirium Severity Score for Older Adults and Association With Hospital and Posthospital Outcomes.JAMA network open · 2022Article
- Comparative Implementation of a Brief App-Directed Protocol for Delirium Identification by Hospitalists, Nurses, and Nursing Assistants : A Cohort Study.Annals of internal medicine · 2022Article
- Delirium Item Bank: Utilization to Evaluate and Create Delirium Instruments.Dementia and geriatric cognitive disorders · 2022Article
- Predictors of Caregiver Burden in Delirium: Patient and Caregiver Factors.Journal of gerontological nursing · 2021Article
- Does Alzheimer's Disease and Related Dementias Modify Delirium Severity and Hospital Outcomes?Journal of the American Geriatrics Society · 2020Article
- New Delirium Severity Indicators: Generation and Internal Validation in the Better Assessment of Illness (BASIL) Study.Dementia and geriatric cognitive disorders · 2020Article
- The Caregiver Burden of Delirium in Older Adults With Alzheimer Disease and Related Disorders.Journal of the American Geriatrics Society · 2019Article
- Use of an expert panel to identify domains and indicators of delirium severity.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019Observational
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND/
objectivesTo describe the design, procedures, and cohort for the Better ASsessment of ILlness -(BASIL) study, which is conducted to develop and test new delirium severity measures, compare them with existing measures, and examine related clinical outcomes.
methodsProspective cohort study with 1 year follow-up of study participants at a large teaching hospital in Boston, Massachusetts. After brief cognitive testing and the Delirium Symptom Interview, delirium and delirium severity were rated daily in the hospital using the Confusion Assessment Method (CAM) and CAM-Severity score, the Delirium Rating Scale-Revised-98 (DRS-R-98), and the Memorial Delirium Assessment Scale (MDAS). Other key study variables included comorbidity, physical function (basic and instrumental activities of daily living [ADL]), ratings of subjective health and well-being, and clinical outcomes (length of stay, 30 day rehospitalization, nursing home admission, healthcare utilization). Follow-up interviews occurred at 1- and 12-month with patients and families. In 42 patient interviews, inter-rater reliability for key variables was assessed.
resultsOf 768 eligible patients approached, 469 were screened and 352 enrolled, yielding an overall study response rate of 67% for potentially eligible participants. The mean participant was 80.3 years old (SD 6.8) and 203 (58%) were female. The majority of patients were medically complex with Charlson Comorbidity Scores ≥2 (192 patients, 55%), and 102 (29%) met criteria for dementia. Inter-rater reliability assessments (n = 42 pairs) were high for overall ratings of presence or absence of delirium by CAM (κ = 1.0), delirium severity by DRS-R-98 and MDAS (weighted kappa, κ = 1.0 for each) and for ADL impairment (κ = 1.0). For eligible participants at each time point, 278 out of 308 (90%) completed the 1-month follow-up and 132 out of 256 (53%) have completed the 12-month follow-up to date, which is still in progress. Among those who completed interviews, there was only 1-3% missing data on most major outcomes (delirium, basic ADL, and readmission).
conclusionThe BASIL study presents an innovative effort to advance the conceptualization and measurement of delirium severity. Unique strengths include the diverse cohort with complete high quality data and longitudinal follow-up, along with detailed collection of multiple delirium measures daily during hospitalization.
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