Validity and reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients.

Détails

ID Serval
serval:BIB_88E0E4809C86
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Validity and reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients.
Périodique
Journal of Critical Care
Auteur(s)
Guenther U., Popp J., Koecher L., Muders T., Wrigge H., Ely E.W., Putensen C.
ISSN
1557-8615 (Electronic)
ISSN-L
0883-9441
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
25
Numéro
1
Pages
144-151
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Validation StudiesPublication Status: ppublish
Résumé
PURPOSE: Delirium occurs frequently in critical care but often remains undiagnosed because delirium monitoring is often dismissed as being too time-consuming. This study determined the validity and reliability of the "CAM-ICU Flowsheet," a practical, time-sparing algorithm to assess the 4 delirium criteria in intubated patients.
MATERIALS AND METHODS: With permission from our institution's ethics committee, patients of a 31-bed surgical intensive care unit department were screened for delirium (1) by a psychiatrist as the reference rater using the 4 delirium criteria of the Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition (DSM-IV), and (2) by 2 physician investigators using a German translation of the CAM-ICU Flowsheet.
RESULTS: Fifty-four surgical ICU patients underwent the complete protocol assessment with paired observations; 46% were diagnosed with delirium by the reference rater (n = 25), 9% had hyperactive delirium (n = 5), and 37% were hypoactive (n = 20). The CAM-ICU Flowsheet investigators had sensitivities of 88% (95% confidence interval, 69%-98%) and 92% (74%-99%), specificities of 100% (85%-100%), very high interrater reliability (kappa, 0.96; 0.87-1.00), and needed 50 seconds (interquartile range, 40-120 seconds) in patients with delirium vs 45 seconds (interquartile range, 40-75 seconds) in those without delirium to complete assessments.
CONCLUSIONS: The CAM-ICU Flowsheet has high sensitivity, high specificity, and very high interrater reliability. False-negative ratings can occur infrequently and mostly reflect the fluctuating course of delirium. The CAM-ICU Flowsheet is a valid, reliable, and quickly performed bedside delirium instrument.
Mots-clé
Age Factors, Aged, Algorithms, Delirium/diagnosis, Delirium/epidemiology, Female, Humans, Intensive Care/methods, Male, Middle Aged, Prevalence, Psychiatric Status Rating Scales, Reproducibility of Results, Sensitivity and Specificity
Pubmed
Création de la notice
29/10/2012 11:05
Dernière modification de la notice
20/08/2019 14:47
Données d'usage