Comparing the CAM-ICU and ICDSC for assessing delirium in non-intubated intensive care patients

Abstract

Aim:The study compared two instruments for detecting delirium, the Intensive Care Delirium Screening Checklist (ICDSC) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) as a reference method. Design: Prospective observational study. Methods: The study included 126 consecutive patients staying in the intensive care unit (ICU) for more than 24 hours. The diagnostic properties of both questionnaires and agreement between them were studied and compared. Additionally, the two tests were used to assess the relationship between selected patient parameters and the presence of delirium. Results: There was a high level of agreement between the CAM-ICU and ICDSC, as expressed by Cohen's κ of 0.829 (95% CI: 0.821-0.838). Cronbach's α assessing the internal consistency of a Czech version of the CAM-ICU and ICDSC was 0.903 and 0.865, respectively. The CAM-ICU had 85.5% sensitivity (95% CI: 84.6-91.8) and 94.1% specificity (95% CI: 92.4-95.5); the ICDSC (cut-off ≥ 4) had 90.6% sensitivity (95% CI: 87.0-93.5) and 89.0% specificity (95% CI: 86.8-91.0). Conclusion: Both compared diagnostic instruments, the CAM-ICU and ICDSC, appear to be adequate and usable. When compared with the CAM-ICU as a reference method, the ICDSC showed similar results and a good level of agreement.