Comparison of the confusion assessment method for the intensive care unit (CAM-ICU) with the Intensive Care Delirium Screening Checklist (ICDSC) for delirium in critical care patients gives high agreement rate(s)

Plaschke, Konstanze; Haken, Rebecca von; Scholz, M.; Engelhardt, R.; Brobeil, Angelika; Martin, Eike; Weigand, Markus A.

doi:10.1007/s00134-007-0920-8

Cited by 119 publications

(81 citation statements)

References 19 publications

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“…Among assessable patients at 14 days, those who were ever delirious had a higher (worse) median NIHSS (11 [6][7][8][9][10][11][12][13][14][15][16][17][18][19] vs. 3 [1][2][3][4][5][6][7][8][9][10][11][12][13][14]; P ¼ 0.002) and a higher (worse) median mRS (5 [4][5] vs. 4 [2][3][4][5]; P ¼ 0.003). In multivariate models, being ever delirious was associated with increased odds of poor outcome (mRS >3 vs. mRS <2) at 28 days (odds ratio [OR], 8.7; 95% CI, 1.4-52.5; P ¼ 0.018) after correction for admission NIHSS (1.5 per point; 95% CI, 1.1-1.9; P ¼ 0.003) and age (OR, 1.06 per year; 95% CI, 1.006-1.1; P ¼ 0.03).…”

Section: Functional Outcomes Among Assessable Patientsmentioning

confidence: 99%

“…The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is a commonly used and well-validated instrument (11)(12)(13)(14) that could be used to track the presence of absence or such a symptom complex in the neuro-ICU patient population (7,10,15). Some distinguish between hyperactive (agitated) delirium and hypoactive delirium ("encephalopathy") depending on the level of arousal.…”

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confidence: 99%

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Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort

Naidech

Beaumont²,

Rosenberg³

et al. 2013

Am J Respir Crit Care Med

100

105

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Rationale: The prognostic significance of delirium symptoms in intensive care unit (ICU) patients with focal neurologic injury is unclear. Objectives: To determine the relationship between delirium symptoms and subsequent functional outcomes and quality of life (QOL) after intracerebral hemorrhage. Methods: We prospectively enrolled 114 patients. Delirium symptoms were routinely assessed twice daily using the Confusion Assessment Method for the ICU by trained nurses. Functional outcomes were recorded with modified Rankin Scale (scored from 0 [no symptoms] to 6 [dead]), and QOL outcomes with Neuro-QOL at 28 days, 3 months, and 12 months. Measurements and Main Results: Thirty-one (27%) patients had delirium symptoms ("ever delirious"), 67 (59%) were never delirious, and the remainder (14%) had persistent coma. Delirium symptoms were nearly always hypoactive, were detected mean 6 days after intracerebral hemorrhage presentation, and were associated with longer ICU length of stay (mean 3.5 d longer in ever vs. never delirious patients; 95% confidence interval, 1.5-8.3; P ¼ 0.004) after correction for age, admit National Institutes of Health (NIH) Stroke Scale, and any benzodiazepine exposure. Delirium symptoms were associated with increased odds of poor outcome at 28 days (odds ratio, 8.7; 95% confidence interval, 1.4-52.5; P ¼ 0.018) after correction for admission NIH Stroke Scale and age, and with worse QOL in the domains of applied cognition-executive function and fatigue after correcting for the NIH Stroke Scale, age, benzodiazepine exposure, and time of follow-up. Conclusions: After focal neurologic injury, delirium symptoms were common despite low rates of infection and sedation exposure, and were predictive of subsequent worse functional outcomes and lower QOL. Keywords: delirium; outcomes; quality of lifeThe symptoms of delirium, a potential consequence of multiple clinical disease states and physiologic aberrations, include a shift in baseline mental status, inattention, and disorganized thinking or altered level of consciousness. Although nonspecific, this syndrome is an independent predictor of higher mortality (1), longer length of stay (LOS), higher cost of care, and worse long-term cognitive outcomes in medical, surgical, burn, and trauma intensive care unit (ICU) patients (2). There are few such data, however, in ICU patients with focal neurologic injury without systemic illness.Risk factors for delirium symptoms are typically global (infection [3] and intravenous sedation, particularly benzodiazepines [BZDs]) (4, 5) as opposed to focal lesions (e.g., hematoma). Most mechanically ventilated patients are delirious during hospitalization (1), potentially because of the sedation regimen (e.g., BZD infusion), but sedation is typically minimized in neurologically injured patients to permit repeated neurologic assessment that may lead to an acute intervention (6).Screening tests for delirium have been recently validated in neurologically ill patients (7-9), including ischemic stroke (7, 10) and intracerebra...

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Section: Functional Outcomes Among Assessable Patientsmentioning

confidence: 99%

mentioning

confidence: 99%

Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort

Naidech

Beaumont²,

Rosenberg³

et al. 2013

Am J Respir Crit Care Med

100

105

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“…En los pacientes de unidad de cuidados intensivos (UCI) los instrumentos diagnósticos son más recientes 51 , siendo el más estudiado el CAM ICU [52][53][54][55][56][57] . Pese a los resultados asociados al DPO, no existe evidencia sólida que evalúe el impacto del tamizaje en los pacientes hospitalizados, concluyendo que el beneficio neto de su uso estaría definido por la edad, comorbilidades y severidad de la enfermedad actual 58 .…”

Section: Métodos Diagnósticosunclassified

Delirium postoperatorio: una consecuencia del envejecimiento poblacional

et al. 2014

Rev. méd. Chile

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“…Flere studier har sammenliknet verktøy som kan avdekke delirium hos intensivpasienten (8, 13,14 (20). Basert på dette valgte vi å bruke retningslinjen «Delirium: diagnosis, prevention and management» (11).…”

Section: Introduksjonunclassified

Kunnskapsbasert vurdering av delirium hos intensivpasienten

Sjøbø¹,

Graverholt²,

Jamtvedt³

2012

Sykepleien

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Comparison of the confusion assessment method for the intensive care unit (CAM-ICU) with the Intensive Care Delirium Screening Checklist (ICDSC) for delirium in critical care patients gives high agreement rate(s)

Abstract: It is concluded from the present investigation that the two scoring methods represent good diagnostic tools with high agreement rates in critical ill ICU patients.

Cited by 119 publications

References 19 publications

Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort

Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort

Delirium postoperatorio: una consecuencia del envejecimiento poblacional

Kunnskapsbasert vurdering av delirium hos intensivpasienten

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