Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: A bivariate meta-analysis

Chen, Ting Jhen; Chung, Yi Wei; Chang, Hui‐Chen; Chen, Pin Yuan; Wu, Chia Rung; Hsieh, Shu Hua; Chiu, Hsiao‐Yean

doi:10.1016/j.ijnurstu.2020.103782

Cited by 82 publications

(58 citation statements)

References 63 publications

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“…It is commonly known that there is an association between ARDS and delirium [12]. Indeed, the appearance of delirium is a common phenomenon both in critically ill [13] and in elderly patients [14]. Although there were no significant findings that the older patients suffer more from the delirium in adult ICU setting [15], the delirium plays a negative impact on the cognitive function in the later life of ICU admitted patients [16].…”

Section: Discussionmentioning

confidence: 99%

Delirium in critically ill patients with COVID-19 pneumonia

2021

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The ICU delirium is a predictor of mortality, length of stay in hospital, time on ventilation, and long-term cognitive impairment. There is a well-established association between acute respiratory distress syndrome (ARDS) and ICU delirium. However, the profile and disease progression trajectory of COVID-19 patients with ICU delirium has not been studied. This case series reviews our institution’s experience in COVID-19 patients with ICU delirium. Of all four patients, two of them died in hospital, and the other two survived to the hospital discharge. The disease progressions were tracked, as well as the ICU delirium. Potential life-threatening complications and organ failure symptoms were also presented. To improve the patients’ overall health outcome, Haloperidol was prescribed with careful consideration.

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Section: Discussionmentioning

confidence: 99%

Delirium in critically ill patients with COVID-19 pneumonia

2021

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“…Kitas ICDSC pliusas yra tas, jog galima įvertinti ir subsindrominį delyrą [25], be to, skalė yra jautresnė (99%), lyginant su CAM-ICU, nors specifiškumas (64%) yra ženkliai mažesnis. ICDSC, lyginant su CAM-ICU, geriau numato baigtis, tačiau CAM-ICU yra tinkamesnis ventiliuojamiems pacientams, patikimiau atmeta delyro diagnozę, jeigu jo nėra [30,31]. Svarbus ICDSC trūkumas yra sunkus sąmoningumo nustatymas, ypač, jei vertintojas nepatyręs, todėl išlieka didelė tikimybė delyro diagnozę nustatyti neteisingai.…”

Section: Diskusija Ar Geriausiai Ištirtos Skalės -Geriausias Pasirinkimas?unclassified

Organinio Delyro Hipodiagnostika: Diagnostikos Perspektyvos Lietuvoje

Kersnauskaitė¹,

Kirtiklytė²,

Navickas³

et al. 2021

Health Sciences

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Lietuvoje stebima delyro hipodiagnostikos problema, kurią aiškinti būtų galima bendrosios delyro diagnozavimo taktikos, kurią galėtų taikyti įvairių specialybių gydytojai, nebuvimu. Yra nemažai standartizuotų diagnostikos ir atrankos skalių, kurios naudojamos nustatant delyro diagnozę. Tyrimo tikslas. Išanalizuoti validuotus delyro atrankos ir diagnostikos metodus, plačiausiai taikomus klinikinėje praktikoje. Tyrimo metodika. Atlikta 11 delyro atrankos ir diagnostikos metodų apžvalga; atrinkti metodai lyginti vieni su kitais pagal skalės paskirtį, jautrumą, specifiškumą, vertintoją, vertinimo trukmę ir skalėje vertinamus parametrus. Rezultatai. Iš 11 atrinktų skalių daugiausiai informacijos radome apie NEECHAM (95-97,2% jautrumas ir 78-82,8% specifiškumas), Nu-DESC (85,7% ir 86,8%) ir CAM (46-100% ir 63-100%) metodus. Intensyviosios terapijos pacientams vertinti tinkami penki iš aprašytų metodų: NEECHAM, ICDSC, CAM, CTD ir DDS. Iš jų dažniausiai naudojamos NEECHAM ir CAM (CAM-ICU modifikacija) bei ICDSC. Senyvo amžiaus pacientams labiausiai tinkamos CAM ir Nu-DESC skalės. Dauguma skalių vertina dėmesingumą, orientaciją, sąmonės pokyčius, kalbėjimo ir judesių tikslingumą. Pakartotinis vertinimas reikalingas Nu-DESC, DOSS ir ICDSC metodams. Dauguma skalių, išskyrus ICDSC ir Nu-DESC, neaptinka hipoaktyvios delyro formos. Išvados. Lietuvoje stebima delyro hipodiagnostikos problema, kurią spręsti būtų galima pasitelkiant validuotas delyro stebėsenos ir diagnostikos skales. Intensyviojoje terapijoje patikimiausios delyro vertinimo skalės yra CAM-ICU, ICDSC ir DDS. Senyvo amžiaus pacientams patartina taikyti CAM ir Nu-DESC metodus bei IQCODE klausimyną. Hipoaktyvaus delyro vertinimui geriausiai tinka ICDSC bei Nu-DESC metodai. Vis dėlto, esant delyro atrankos ir diagnostikos skalių įvairovei, išlieka poreikis trumpos, greitai ir paprastai pritaikomos, aukšto jautrumo ir specifiškumo suvienodintos vertinimo skalės, tinkamos įvertinti ne tik delyro faktą, bet ir jo subtipą.

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“…The literature indicates that the incidence of delirium in patients is 20-40% in ICU and 60-80% in ventilated patients. [1][2][3][4] In older patients, the incident rate increases considerably. 5,6 According to some anesthesiologists, the primary challenges of ICU delirium treatment associate with two conditions.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Risk Factors for Delirium in Elderly Patients in the Emergency Rooms and Intensive Care Unit of the National Geriatric Hospital Emergency Department: A Cross-Sectional Observational Study

Tran¹,

Hoang²,

Ho³

2021

IJGM

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Purpose: To diagnose delirium and identify risk factors for its development in elderly patients in the emergency department (ED) and intensive care units (ICU) at the National Geriatric Hospital (Vietnam). Patients and Methods: A cross-sectional observational study was conducted with a convenience sample of non-surgical patients admitted to ED and ICU at Hanoi National Geriatric Hospital in Vietnam. In total, 163 patients met the selection criteria and were included in the study. Screening involved using the Confusion Assessment Method (CAM) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). The diagnosis was established according to the DSM-5 and ICD-10 codes. Results: Delirium was found in a total of 106 (63.1%) patients. The factors significantly affecting its development were vision impairment (OR, 3.3; 95% CI, 1.5 to 7.4, P=0.003), hearing impairment (OR, 3.6; 95% CI, 1.77 to 7.36, P=0.0001), acute or chronic kidney failure (OR, 7.1; 95% CI, 2.05 to 6.39, P<0.001), respiratory disorders (OR, 2.7; 95% CI, 1.4 to 5.2, P=0.004), and malnutrition (OR, 9.17; 95% CI, 3.43-24.5, P=0.0001). The list also include the fall risk factors (OR, 12.2; 95% CI, 4.1-36.3, P=0.0001), frailty (OR, 8.35; 95% CI, P=0.0001), activities of daily living (OR, 8.35; 95% CI,, P=0.0001), hyponatremia (OR, 2.48; 95% CI, 1.07 to 5.75, P=0.001), hypernatremia (OR, 13.1; 95% CI, 1.67 to 2.5, P=0.001), and treatment interventions. In addition, delirium was linked to the duration of ICU admission (OR, 6.53; 95% CI, 4.5-25.5, P < 0.0001). Conclusion:The CAM/CAM-ICU diagnostic algorithm makes it possible to diagnose delirium successfully. The present study confirmed the role of several premorbid and triggering factors in the occurrence of delirium in elderly patients in ED and ICU. There is a need for further research into risk factors for delirium in elderly patients.

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Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: A bivariate meta-analysis

Cited by 82 publications

References 63 publications

Delirium in critically ill patients with COVID-19 pneumonia

Delirium in critically ill patients with COVID-19 pneumonia

Organinio Delyro Hipodiagnostika: Diagnostikos Perspektyvos Lietuvoje

Diagnosis and Risk Factors for Delirium in Elderly Patients in the Emergency Rooms and Intensive Care Unit of the National Geriatric Hospital Emergency Department: A Cross-Sectional Observational Study

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