Delirium and delirium severity screening in the intensive care-correspondence of screenings tools

Marie Oxenbøll Collet*, Anne H Nielsen, Laura K Larsen, Eva Laerkner, Janet Froulund Jensen, Camilla B Mortensen, Lene Lehmkuhl, Linette Thorn, Birgitte Sonne Rossen, Tina Allerslev Nielsen, Edel Laursen, Louise Hvid Shiv, Marianne Villumsen, Mette Nygaard Rahr, Helle Svenningsen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

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 agewas 70 years (interquartile range: 61e77), 40% (339/850)were female, and 54% (457/850) had at
least one positive deliriumscore.Deliriumseverity ranges (CAM-ICU-7: 0e7; andICDSC: 0e8)were positively
correlated (Pearson's correlation coefficient, r ¼ 0.83; p < 0.0001). The overall agreement between the CAMICU-
7 and the ICDSC for delirium measurement (CAM-ICU-7: >2, and ICDSC: >3) was substantial
(kappa ¼ 0.74), but the agreement decreased to fair (kappa ¼ 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.
OriginalsprogEngelsk
TidsskriftAustralian Critical Care
Vol/bind37
Nummer3
Sider (fra-til)407-413
Antal sider7
ISSN1036-7314
DOI
StatusUdgivet - maj 2024

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  • DELIS-3: Delirium screening 3 methods study

    Nielsen, A. H. (PI), Svenningsen, H. (Projektleder), Oxenbøll-Collet, M. (Deltager) & Larsen, L. K. (PI)

    01/01/202031/12/2022

    Projekter: ProjektForskning

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