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)

Konstanze Plaschke, Rebecca von Haken, Mirijam Scholz, Ria Engelhardt, Angelika Brobeil, Eike Martin, Markus A Weigand
Intensive Care Medicine 2008, 34 (3): 431-6

OBJECTIVE: In the intensive care unit (ICU) we assessed the agreement between the delirium ratings of two independent delirium assessment methods: (a) the Confusion Assessment method for the ICU (CAM-ICU); and (b) the Intensive Care Delirium Screening Checklist (ICDSC).

DESIGN: Prospective, descriptive cohort study.

SETTING AND PATIENTS: During a 6-month period, 174 patients (mean age 62.4+/-13.0 years) admitted to the ICU after elective surgery or after an emergency were included and assessed with both delirium assessment systems by two trained independent investigators (research person and bedside nurses) during their ICU stay or for up to 7 days after ICU admission.

INTERVENTIONS: Patients' clinical characteristics at ICU admission day were documented.

MEASUREMENTS AND RESULTS: After excluding permanently unconscious patients with <or=-4 on the Richmond Agitation Sedations scale, delirium was identified in 71 of the 174 patients (41%). The patients who were included were tested in 374 paired but researcher-independent ratings of delirium by both scoring methods. The kappa coefficient determined over 7 days of ICU stay was 0.80 (CI 95%: 0.78-0.84; p<0.001), indicating good agreement.

CONCLUSION: 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.

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