Delirium, introduction to a confused mind

Rompaey, Bart Van; Sabbe, Kelly; Dilles, Tinne; Boogaard, Mark van den

doi:10.1016/j.iccn.2018.06.003

Cited by 4 publications

(1 citation statement)

References 37 publications

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“…Delirium is a common neuropsychiatric complication in an intensive care unit (ICU) with an incidence rate of 26%, and the prevalence of delirium in mechanically ventilated patients is as high as 80% (Sanchez-Hurtado et al, 2018;van den Boogaard, Schoonhoven, van der Hoeven, van Achterberg, & Pickkers, 2012;Setters & Solberg, 2017). Delirium is defined as resulting disturbances in attention, awareness, orientation, and cognition (Neufeld & Thomas, 2013) and often leads to adverse outcomes such as prolonged ICU admissions, persisting cognitive dysfunction, and increased mortality rate (Marcantonio, 2017;McCoy, 2018;Van Rompaey, Sabbe, Dilles, & Van den Boogaard, 2018). Delirium is underdiagnosed in ICUs, particularly in cases of mechanically ventilated patients.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance of Delirium Assessment Tools in Critically Ill Patients: A Systematic Review and Meta‐Analysis

Montgomery

Traynor

et al. 2020

Worldviews Ev Based Nurs

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Background Critical care nurses are in the best position to detect and monitor delirium in critically ill patients. Therefore, an optimum delirium assessment tool with strong evidence should be identified with critical care nurses to perform in the daily assessment. Aim To evaluate and compare the diagnostic performance of delirium assessment tools in diagnosing delirium in critically ill patients. Methods We searched five electronic databases including the Cochrane Library, PubMed, Embase, CINAHL, and a Chinese database for eligible diagnostic studies published in English or Mandarin up to December 2018. This diagnostic test accuracy meta‐analysis was limited to studies in intensive care unit (ICU) settings, using the Diagnostic and Statistical Manual of Mental Disorders (DSM) as a standard reference to test the accuracy of delirium assessment tools. Eligible studies were critically appraised by two investigators independently. The summary of evidence was conducted for pooling and comparing diagnostic accuracy by a bivariate random effects meta‐analysis model. The pooled sensitivities and specificities, summary receiver operating characteristic curve (sROC), the area under the curve (AUC), and diagnostic odds ratio (DOR) were calculated and plotted. The possibility of publication bias was assessed by Deeks’ funnel plot. Data Synthesis We identified and evaluated 23 and 8 articles focused on CAM‐ICU and ICDSC, respectively. The summary sensitivities of 0.85 and 0.87, and summary specificities of 0.95 and 0.91 were found for CAM‐ICU and ICDSC, respectively. The AUC of the CAM‐ICU was 0.96 (95% CI, 0.94–0.98), with DOR at 99 (95% CI, 55–177). The AUC of the ICDSC was 0.95 (95% CI, 0.92–0.96), and the DOR was 65 (95% CI, 27–153). Linking Evidence to Action CAM‐ICU demonstrated higher diagnostic test accuracy and is recommended as the optimal delirium assessment tool. However, the results should be interpreted with caution due to the between‐study heterogeneity of this diagnostic test accuracy meta‐analysis.

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