TY - JOUR
T1 - Delirium and delirium severity screening in the intensive care-correspondence of screenings tools
T2 - Correspondence of Screenings Tools
AU - Collet, Marie O
AU - Nielsen, Anne H
AU - Larsen, Laura K
AU - Laerkner, Eva
AU - Jensen, Janet Froulund
AU - Mortensen, Camilla B
AU - Lehmkuhl, Lene
AU - Thorn, Linette
AU - Rossen, Birgitte Sonne
AU - Nielsen, Tina Allerslev
AU - Laursen, Edel
AU - Shiv, Louise Hvid
AU - Villumsen, Marianne
AU - Rahr, Mette Nygaard
AU - Svenningsen, Helle
AU - Rasmussen, Birgitte Sonne
AU - Allerslev, Tina
N1 - Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
PY - 2023/7/10
Y1 - 2023/7/10
N2 - BACKGROUND: Delirium severity scores are gaining acceptance for measuring delirium in the intensive care unit (ICU).OBJECTIVE: The aim of this study was to evaluate the concordance between the Confusion Assessment Method for the intensive care unit (CAM-ICU)-7 and the Intensive Care Delirium Screening Checklist (ICDSC) as delirium severity measurement tools.METHODS: This was a prospective, comparative, observational multicentre study. This study was conducted in 18 Danish ICUs. Delirium was assessed in adult critically ill patients admitted to an ICU with a Richmond Agitation and Sedation Score (RASS) of -2 or above. ICU nurses assessed delirium with randomised paired delirium screening instruments, using the CAM-ICU, the ICDSC, and the CAM-ICU-7. The correlation between the CAM-ICU-7 and the ICDSC severity scores was evaluated for all predefined patient subgroups.RESULTS: A total of 1126 paired screenings were conducted by 127 ICU nurses in 850 patients. The patients' median age was 70 years (interquartile range: 61-77), 40% (339/850) were female, and 54% (457/850) had at least one positive delirium score. Delirium severity ranges (CAM-ICU-7: 0-7; and ICDSC: 0-8) were positively correlated (Pearson's correlation coefficient, r = 0.83; p < 0.0001). The overall agreement between the CAM-ICU-7 and the ICDSC for delirium measurement (CAM-ICU-7: >2, and ICDSC: >3) was substantial (kappa = 0.74), but the agreement decreased to fair (kappa = 0.38) if a patient had a RASS less than 0.CONCLUSIONS: The agreement between the CAM-ICU-7 and the ICDSC for delirium severity measurement was substantial but might be affected by the patient's sedation and agitation level at the time of assessment.IMPLICATIONS FOR PRACTICE: Both CAM-ICU-7 and ICDSC can be implemented for delirium severity measurement. Attention is warranted in both scores if a patient has a RASS of -2.
AB - BACKGROUND: Delirium severity scores are gaining acceptance for measuring delirium in the intensive care unit (ICU).OBJECTIVE: The aim of this study was to evaluate the concordance between the Confusion Assessment Method for the intensive care unit (CAM-ICU)-7 and the Intensive Care Delirium Screening Checklist (ICDSC) as delirium severity measurement tools.METHODS: This was a prospective, comparative, observational multicentre study. This study was conducted in 18 Danish ICUs. Delirium was assessed in adult critically ill patients admitted to an ICU with a Richmond Agitation and Sedation Score (RASS) of -2 or above. ICU nurses assessed delirium with randomised paired delirium screening instruments, using the CAM-ICU, the ICDSC, and the CAM-ICU-7. The correlation between the CAM-ICU-7 and the ICDSC severity scores was evaluated for all predefined patient subgroups.RESULTS: A total of 1126 paired screenings were conducted by 127 ICU nurses in 850 patients. The patients' median age was 70 years (interquartile range: 61-77), 40% (339/850) were female, and 54% (457/850) had at least one positive delirium score. Delirium severity ranges (CAM-ICU-7: 0-7; and ICDSC: 0-8) were positively correlated (Pearson's correlation coefficient, r = 0.83; p < 0.0001). The overall agreement between the CAM-ICU-7 and the ICDSC for delirium measurement (CAM-ICU-7: >2, and ICDSC: >3) was substantial (kappa = 0.74), but the agreement decreased to fair (kappa = 0.38) if a patient had a RASS less than 0.CONCLUSIONS: The agreement between the CAM-ICU-7 and the ICDSC for delirium severity measurement was substantial but might be affected by the patient's sedation and agitation level at the time of assessment.IMPLICATIONS FOR PRACTICE: Both CAM-ICU-7 and ICDSC can be implemented for delirium severity measurement. Attention is warranted in both scores if a patient has a RASS of -2.
KW - disease, health science and nursing
KW - Intensive Care Units
KW - critical illness/psychology
KW - delirium
KW - delirium severity
KW - screening method
U2 - https://doi.org/10.1016/j.aucc.2023.05.007
DO - https://doi.org/10.1016/j.aucc.2023.05.007
M3 - Journal article
C2 - 37438182
SN - 1036-7314
JO - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
M1 - S1036731423000826
ER -