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AWOL Score for Delirium

Predicts risk of incident delirium in hospitalised medical patients at admission.

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.