AWOL-S: Age, WORLD backwards, Orientation, iLlness severity and Surgery-specific risk

2020

A perioperative extension of AWOL that estimates postoperative delirium probability using age, brief cognition, illness severity and surgical risk. It predicts risk rather than detecting delirium.

Classification

Future-risk prediction

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Tool and original sources

This record describes a method rather than a downloadable bedside form. The main source is linked below.

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Original paper

Principal sourceWhitlock EL, Braehler MR, Kaplan JA, Finlayson E, Rogers SE, Douglas V, et al. Derivation, Validation, Sustained Performance, and Clinical Impact of an Electronic Medical Record-Based Perioperative Delirium Risk Stratification Tool. Anesthesia and analgesia. 2020;131(6):1901-1910. doi: 10.1213/ANE.0000000000005085. PMID: 33105280.
This paper reports the derivation and initial validation of AWOL-S itself. It is the main source for the method, its intended use and the evidence available at publication.
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No eligible DTA study identifiedRelated context

At a glance

Purpose: Future-risk prediction
Population: Adults undergoing surgery with at least an overnight hospital stay
Setting: Perioperative, General / acute hospital
Time: brief preoperative assessment plus electronic calculation; formal time not reported
Items: 5
Score or threshold: Five per cent predicted probability was used operationally in the source programme; local calibration is required

Evidence

Evidence maturityNo eligible DTA study identified

Reported sensitivity and specificity

approximately 75% at the 5% threshold

Sensitivity

approximately 59-60% at the 5% threshold

Specificity

Model AUROC was 0.71 in derivation, 0.65 in validation and 0.75 during sustained performance.

More evidence and citation details

Full name: Age, WORLD backwards, Orientation, iLlness severity and Surgery-specific risk
Related profiles: AWOL
Evidence summary: derivation-validation-and-sustained-performance-cohorts
Citation: Whitlock EL, et al. Derivation, validation, sustained performance, and clinical impact of an electronic medical record-based perioperative delirium risk stratification tool Anesthesia & Analgesia. 2020;131(6):1901-1910. PMID 33105280

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Information checked: 2026-07-19

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Sources checked 2026-07-29. How profiles are prepared.