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CAM-S: Confusion Assessment Method – Severity

2014

CAM-S is a CAM-derived method for rating delirium severity. It supports repeated description of symptom burden rather than serving as a standalone screening form.

At a glance

Purpose
Measurement of delirium severity
Population
Adult
Setting
General / acute hospital, Perioperative
Time
derived from an underlying CAM assessment; no separate completion time reported
Items by form
4 short form / 10 long form
Score or threshold
Short 0–7; long 0–19

Format: CAM-S converts CAM findings into delirium-severity scores using a 4-item short form or 10-item long form. The reported ranges are 0-7 and 0-19 respectively. Feature wording, weights, anchors and scoring steps are not reproduced here.

  • Strengths: Validated in independent cohorts of 300 older surgical and 919 older medical patients; increasing scores were associated with length of stay and 90-day death or nursing-home residence
  • Limitations: Requires the CAM to be scored first

How CAM-S severity scoring differs from the short and long CAM diagnostic forms.

Primary validation papers

0 identified diagnostic-accuracy papers

Other forms of validation are described in the evidence section. What is counted?

Large-scale clinical implementation

None identified in the scoped review.

None identified in the selected profile sources and the Penfold general-hospital review. This is not a completed search of all settings or later papers.

Training and instructions

  • CAM-S training manual. Developer resource page with the instrument-specific manual. Check the current version and reuse terms.
  • CAM-S manual or instructions. Public manual or instructions checked on 5 September 2026. Follow the source’s version and permission conditions.
Start here

Tool and original sources

Copyright restrictions mean that a copy of CAM-S cannot be provided on this website. Use the official access page below.

Open the official tool page ↗ Read the full paper ↗

Original paper

  • Principal sourceInouye SK, Kosar CM, Tommet D, Schmitt EM, Puelle MR, Saczynski JS, et al. The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts. Annals of internal medicine. 2014;160(8):526-533. doi: 10.7326/M13-1927. PMID: 24733193.

    This paper reports the development and initial validation of CAM-S itself. It is the main source for the method, its intended use and the evidence available at publication.

    Open PubMed ↗
No eligible DTA study identifiedVersion or adaptation
Classification

Classification

Measurement of delirium severity

A tool may belong to more than one category. Select a linked category to see other relevant profiles.

Evidence

Diagnostic-accuracy evidenceNo eligible DTA study identified

Reported sensitivity and specificity

;
Sensitivity
;
Specificity

Validated in independent cohorts of 300 older surgical patients and 919 older medical patients. Increasing CAM-S severity was associated with longer stay and higher 90-day risk of death or nursing-home residence.

More evidence and citation details
Full name
Confusion Assessment Method – Severity
Also known as
CAM-S, CAM Severity, Confusion Assessment Method Severity
Related profiles
CAM
Evidence summary
psychometric-validation
Reference standard
CAM (add-on)
Reliability
;
Citation
Inouye SK, Kosar CM, Tommet D, Schmitt EM, Puelle MR, Saczynski JS, Marcantonio ER, Jones RN The CAM-S: development and validation of a new scoring system for delirium severity in 2 cohorts Annals of internal medicine. 2014;160(8):526-533. PMID 24733193
Download RIS ↗ Download BibTeX ↗

Primary validation studies

Distinct primary publications from the current diagnostic-accuracy audit. Reviews and repeated evaluations within one paper are not counted again. Overlapping cohorts have not all been reconciled. Read the counting rules and limitations.

No eligible diagnostic-accuracy paper is currently included in this audit. This does not mean the tool has never been validated. The source paper and other evidence on this profile may concern severity, reliability or another measurement purpose.

Copyright and reuse
Version
Use the current CAM-S supplied by the author-led resource page
Rights holder
Hospital Elder Life Program (copyright); Aging Brain Center (permissions administrator)
Licence
ALL-RIGHTS-RESERVED-PERMISSION-REQUIRED
Information checked
2026-07-19

Instrument-specific terms apply. See the access and copyright policy or send a correction.

Base clinical review: 2026-07-29. Instrument description source check: 2026-09-05. Scope and limitations.