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The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium
Cameron A. Rivera, David Kunkel, Maihlee Her, Simran Qureshi, Robert A. Pearce, Robert David Sanders, Richard C. Lennertz. BJA Open, 2025-04-21
Topic: Risk, prevention and care in population studies
Background Several methods are used to measure delirium severity in the postoperative period. Here, we compare severity scores from two common assessment methods: the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) and the Delirium Rating Scale–Revised–98 (DRS). Methods Data were collected as part of an ongoing observational cohort study of perioperative delirium in patients >65 yr old undergoing major elective surgery with an anticipated hospital stay of at least 2 days. Patients were excluded if they had a documented history of dementia, resided in a nursing home, underwent neurosurgery, or could not complete neurocognitive testing. Patients underwent paired 3D-CAM and DRS assessments before and after operation along with EEG, cognitive testing, and plasma biomarker analysis. Results Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments. Peak 3D-CAM severity (3D-CAM-S) scores correlated with peak DRS severity scores, for both the raw (ρ=0.74, P <0.001) and short form method (ρ=0.66, P <0.001). Peak 3D-CAM-S raw scores also correlated with delirium duration and severity duration area under the curve measures (ρ=0.71, P <0.001 and ρ=0.91, P <0.001, respectively). Similar to prior reports with the DRS, 3D-CAM-S raw scores correlated with worse performance on the Trail Making Test B (ρ=0.37, P <0.001, n =177), slow-wave electroencephalogram power (ρ=0.3, P =0.001, n =73), and plasma neurofilament light (ρ=0.26, P <0.05, n =61) and tau (ρ=0.41, P <0.001, n =63). Conclusions The 3D-CAM-S severity scores correlated with DRS, delirium duration, and biomarkers of delirium. The 3D-CAM, which is easier to implement than the DRS in postoperative patients, may provide a comparable assessment of delirium severity in this population. Clinical trial registration NCT03124303.
Key findings
- Results Of 226 subjects enrolled, 204 completed both the 3D-CAM and DRS assessments.
Why it matters
In patients over 65 having major elective surgery, a shorter delirium severity score matched a longer established rating scale and correlated with delirium duration and biomarkers. This is about measuring delirium severity, not treating or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Participants177
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BJA Open) |
| Journal's citation record | 0 / 4 | BJA Open: journal h-index 18 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 177 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 3 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Richard C. Lennertz: h-index 17 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Wisconsin–Madison: institution h-index 1,518 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40331035) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Rivera, C. A., Kunkel, D., Her, M., Qureshi, S., Pearce, R. A., Sanders, R. D., et al. (2025). The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium. BJA Open. https://doi.org/10.1016/j.bjao.2025.100398
Vancouver
Rivera CA, Kunkel D, Her M, Qureshi S, Pearce RA, Sanders RD, et al. The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium. BJA Open. 2025. doi:10.1016/j.bjao.2025.100398. PMID: 40331035.
BibTeX
@article{rivera2025-40331035,
author = {Rivera, Cameron A. and Kunkel, David and Her, Maihlee and Qureshi, Simran and Pearce, Robert A. and Sanders, Robert David and Lennertz, Richard C.},
title = {{The 3-Minute Diagnostic Confusion Assessment Method severity score correlates with the Delirium Rating Scale–Revised–98 and with biomarkers of delirium}},
journal = {BJA Open},
year = {2025},
doi = {10.1016/j.bjao.2025.100398},
pmid = {40331035},
url = {https://doi.org/10.1016/j.bjao.2025.100398}
}
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