Aims
To evaluate the diagnostic properties of the Thai version of 3D-CAM among hospitalised older adults.
Methods
A cross-sectional study was conducted at a tertiary hospital in Thailand from July to November 2024. The 3D-CAM was translated into Thai with cultural adaptation. The participants included were aged 70 and older, admitted to medical or orthopaedic wards, fluent in Thai, and expected to stay for more than two days. Delirium was assessed independently using the Thai 3D-CAM by trained research assistants against the reference standard, DSM-5 criteria, by an expert over two days. The study analysed the diagnostic performance of the Thai 3D-CAM and the correlation between its severity scores and hospital length of stay (LOS).
Results
One hundred and fifty-four patients were included in this study. The prevalence of delirium was 40.9%. The most common motor subtype was hyperactive delirium (21.4%), followed by mixed-type delirium (12.9%). The sensitivity of the 3D-CAM TH was 89.91% (95% CI; 82.66–94.85), and the specificity was 91.96% (95% CI; 82.27–95.33). The test exhibited a Cronbach's alpha of 0.853, indicating strong reliability. Regardless of delirium status, higher Thai 3D-CAM scores (≥4/20) independently predict longer LOS, with an increase of approximately 3.33 days (95% CI; 1.15–5.51, p = 0.003).
Conclusions
The Thai 3D-CAM is a practical and effective screening tool for identifying delirium and has extended benefits to predict the LOS in older adults admitted to the hospital. It shows strong performance when compared to the gold standard DSM-5 criteria.