The observational scale of level of arousal: a brief tool for assessing and monitoring level of arousal in patients with delirium outside the ICU

Roanna Hall, Antaine Stiobhairt, Mike Allerhand, Alasdair M.J. MacLullich, Zoe Tieges*

*Corresponding author for this work

Research output: Contribution to journalArticle

57 Downloads (Pure)

Abstract

Objectives: Altered level of arousal, encompassing drowsiness and hypervigilance, affects at least 10% of acutely unwell patients. Existing scales provide limited coverage of milder changes in level of arousal. We devised the Observational Scale of Level of Arousal (OSLA) to enable more detailed arousal assessment. Here, we provide a preliminary case-control study of performance of the OSLA in assessing abnormal level of arousal associated with delirium outside the ICU. Methods: Hip fracture patients (N = 108, median age = 82 years) were assessed for delirium pre- and post-operatively using the Confusion Assessment Method and the Delirium Rating Scale-Revised-98. The OSLA has four graded items assessing eye opening, eye contact, posture, and movement (score range 0 [normal arousal]-15). We assessed the psychometric and diagnostic characteristics of the OSLA. Adjusted linear mixed effects models were used to explore responsiveness of the OSLA to within-patient change in delirium status. Results: A total of 44 patients (40.7%) were diagnosed with delirium. OSLA scores were higher in delirium (pooled median = 3, InterQuartile Range [IQR] = 2-5) compared to no delirium (pooled median = 1, IQR = 1-2; P-values
Original languageEnglish
Pages (from-to)1021-1027
Number of pages7
JournalInternational Journal of Geriatric Psychiatry
Volume35
Issue number9
Early online date11 May 2020
DOIs
Publication statusPublished - Sep 2020

Keywords

  • delirium
  • arousal
  • cognition
  • attention
  • orthopaedic surgery

Fingerprint Dive into the research topics of 'The observational scale of level of arousal: a brief tool for assessing and monitoring level of arousal in patients with delirium outside the ICU'. Together they form a unique fingerprint.

Cite this