• Catherine Bédard, Valerie Boucher, Philippe Voyer, Krishan Yadav, Debra Eagles, Alexandra Nadeau, Pierre-Hugues Carmichael, Mathieu Pelletier, Emilie Gouin, Simon Berthelot, Raoul Daoust, Antoine Laguë, Anne-Julie Gagné, and Marcel Émond.
• Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Hôpital de l'Enfant-Jésus, Québec, Canada; Université Laval, Québec, Canada; Centre d'excellence sur le vieillissement de Québec, Québec, Canada; Centre de Recherche sur les Soins et les Services de Première Ligne de l'Université Laval (CERSSPL-UL), Québec, Canada.
• J Emerg Med. 2019 Jul 1; 57 (1): 59-65.

BackgroundIt is recommended that older patients undergo systematic mental status screening when presenting to the emergency department (ED). However, the tools available are not necessarily adapted to the ED environment, therefore, quicker and easier tools are needed.ObjectivesThe purpose of this study is to validate the Ottawa 3DY-French (O3DY-F) Scale as a screening tool for delirium and cognitive impairment in a French-speaking cohort.MethodThis multicenter prospective study was conducted in four hospitals across the province of Quebec. Inclusion criteria were: age ≥ 65 years, ED stay ≥ 8 h, awaiting admission to a care unit, and independent or semi-independent in their daily living activities. Cognitive status was assessed during the initial interview using the Telephone Interview for Cognitive Screening-modified (TICS-m) and the O3DY-F scale. Comparisons were made between the O3DY-F and the TICS-m and Confusion Assessment Method (CAM) to assess the sensitivity and specificity of the O3DY-F for the detection of cognitive impairment and delirium.ResultsA total of 313 patients were included in this study, 139 of which had a positive O3DY-F. When compared with the CAM, the O3DY-F had a sensitivity of 84.2% (95% confidence interval [CI] 60.4-96.6) and a specificity of 58.2% (95% CI 52.3-63.9) for the detection of prevalent delirium. The O3DY-F had a sensitivity of 76.2% (95% CI 66.7-84.8) and a specificity of 67.6% (95% CI 61.0-73.6) for cognitive impairment (defined as a TICS-m < 27).ConclusionThe O3DY-F is a useful and effective tool to screen for delirium and undetected cognitive impairment among a French-speaking cohort in the ED.Copyright © 2019 Elsevier Inc. All rights reserved.

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