Neuroanesthesia & neurocritical care
Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke
Authors' conclusion
In this validation study, we found that the FMSE was an accurate delirium screening tool in neurocritically ill stroke patients.
Study context
- Population
- Neurocritically ill stroke patients in a neurocritical care unit at an academic medical center717 noncomatose days analysed
- Participants
- 139 patients
- Comparison
- Fluctuating Mental Status Evaluation (FMSE) vs expert DSM-based delirium assessment
- Outcome
- Delirium detection, per assessment
Methodological detailsprospective validation study, single-centre
- Prospective validation study
- Single-centre
Performance
As reported in the abstract
| Strategy | Sensitivity | Specificity |
|---|---|---|
| FMSE ≥ 1 | 86% | 74% |
| FMSE ≥ 2 | 70% | 88% |
Sensitivity
FMSE ≥ 186%
FMSE ≥ 270%
Specificity
FMSE ≥ 174%
FMSE ≥ 288%
- Overall FMSE accuracy, AUC
- 0.85 (95% CI 0.82-0.87)
Further findings
Delirium detection in patients with aphasia (subgroup)
Sensitivity
Specificity
Delirium detection in patients with decreased arousal (subgroup)
Sensitivity
Specificity
Prediction of functional outcome by positive FMSE
- AUC at discharge
- 0.86 (95% CI 0.79-0.93)
- AUC at 3 months
- 0.85 (95% CI 0.78-0.92)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Validating the Fluctuating Mental Status Evaluation in Neurocritically Ill Patients With Acute Stroke. Crit Care Med. Published 4 October 2024. doi:10.
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