🧠 4AT Delirium Screen
UseWhen to use: older inpatients / ED patients with new confusion risk.
Strata≥4 possible delirium; 1–3 possible cognitive impairment; 0 lower likelihood.
LimitsWhen not to use: as DSM delirium diagnosis alone. · Pitfall: skipping acute-change item. · Use CAM-ICU when ventilated ICU pathway applies.
SourceBellelli G et al. 4AT
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
0–12.
When to use
When to use: older inpatients / ED patients with new confusion risk.
How it works
Alertness 0/4 + AMT4 errors 0–2 + attention 0–2 + acute change 0/4 (max 12).
Key points
- 0–12.
- ≥4 delirium cue.
- Next: workup / safety.
References
- Bellelli G et al. 4AT
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Alertness | Normal (0) |
|---|---|
| AMT4 errors (age, DOB, place, year) | 1 error (+1) |
| Attention — months backwards | Starts but <7 months (+1) |
| Acute change or fluctuating course (hours–days) | No (0) |
→4AT2/12
- Cue：1–3 — possible cognitive impairment; monitor / investigate
| Alertness | Normal (0) |
|---|---|
| AMT4 errors (age, DOB, place, year) | 0 errors (0) |
| Attention — months backwards | ≥7 months correct (0) |
| Acute change or fluctuating course (hours–days) | No (0) |
→4AT0/12
- Cue：0 — delirium / significant CI less likely on this screen
Verification & sources · governance
FAQ
Frequently asked questions
- Does 4AT Delirium Screen upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is 4AT Delirium Screen calculated in practice? Can you show a worked example?
- Inputs: Alertness Normal (0), AMT4 errors (age, DOB, place, year) 1 error (+1), Attention — months backwards Starts but <7 months (+1), Acute change or fluctuating course (hours–days) No (0) → Result: 4AT 2 /12（Cue: 1–3 — possible cognitive impairment; monitor / investigate） Inputs: Alertness Normal (0), AMT4 errors (age, DOB, place, year) 0 errors (0), Attention — months backwards ≥7 months correct (0), Acute change or fluctuating course (hours–days) No (0) → Result: 4AT 0 /12（Cue: 0 — delirium / significant CI less likely on this screen）