DEC — Delirium Etiology Checklist

What this tool is and how to interpret its evidence

The Delirium Etiology Checklist is a structured research aid for classifying the likely causes of an established delirium episode. It was used in a prospective cohort of older adults admitted from an emergency department, where three trained physician reviewers examined clinical information and assigned aetiological judgements. The checklist supports consistent review across cases; it does not decide whether delirium is present, replace acute medical assessment or prove that a recorded factor caused the syndrome. Delirium is frequently multifactorial, and a checklist category remains a clinical-research judgement rather than a definitive biological diagnosis.

Cirbus and colleagues studied 228 hospitalised patients aged over 65 years. Delirium was identified separately with a modified Brief Confusion Assessment Method, while the checklist was used to group putative causes for analyses of six-month function and cognition. Some aetiological groups had different outcome associations depending on pre-illness function or cognition. These findings concern prognosis within one cohort and do not validate the checklist as a stand-alone diagnostic device.

The detailed form was supplied with the research publication and should be obtained from that authoritative source. Reproducing every category here would blur the boundary between commentary and the original material. Clinicians investigating delirium should follow local guidance and consider urgent, reversible and interacting causes. The checklist belongs in aetiology and research context, not in the bedside tool count or as a replacement for comprehensive assessment.