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AWOL Score for Delirium

AWOL Score for Delirium
Age 80 years or older
Unable to spell "world" backward correctly
Not oriented to place (disorientation)
Higher nurse-rated illness severity (moderately ill or worse)
Result0 points

Predicted in-hospital delirium incidence about 2%.

Predicted delirium incidence
2%

When to use

  • Stratifying delirium risk at hospital admission in medical inpatients without delirium.
  • Targeting non-pharmacologic delirium prevention to higher-risk patients.

Formula

One point each: Age >=80, unable to spell "World" backward, disOriented to place, higher nurse-rated iLlness severity. Range 0-4.

Pearls and pitfalls

  • Derived and validated in medical inpatients older than 50 years.
  • Delirium risk rose steeply from 2% at 0 points to 64% at 4 points in the combined cohort.

References

  1. Douglas VC, et al. J Hosp Med. 2013;8(9):493-9.