Sensitivity and specificity of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium: A single-center study in Japan

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• 作者：Katsuji Nishimura ; MD ; PhD^a ; ¹ ; ^{nishimura.katsuji@twmu.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Kanako Yokoyama ; MD^a ; ¹ ; Noriko Yamauchi ; RN ; CNS^b ; Masako Koizumi ; RN ; CNS^b ; Nozomi Harasawa ; RN ; PhD^c ; Taeko Yasuda ; RN ; CNS^b ; Chizuru Mimura ; RN^b ; Hazuki Igita ; RN ; CNS^c ; Eriko Suzuki ; MD^a ; Yoko Uchiide ; MD^a ; Yusuke Seino ; MD^d ; Minoru Nomura ; MD ; PhD^d ; Kenji Yamazaki ; MD ; PhD^e ; Jun Ishigooka ; MD ; PhD^a ; TMAD investigators^f
• 关键词：Delirium ; Post-cardiac surgery delirium ; Intensive care unit ; CAM-ICU ; ICDSC
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：45
• 期：1
• 页码：15-20
• 全文大小：746 K

文摘

To compare the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for detecting post-cardiac surgery delirium.

Background

These tools have not been tested in a specialized cardio-surgical ICU.

Methods

Sensitivities and specificities of each tool were assessed in a cardio-surgical ICU in Japan by two trained nurses independently. Results were compared with delirium diagnosed by psychiatrists using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision.

Results

There were 110 daily, paired assessments in 31 patients. The CAM-ICU showed 38% sensitivity and 100% specificity for both nurses. All 20 false-negative cases resulted from high scores in the auditory attention screening in CAM-ICU. The ICDSC showed 97% and 94% sensitivity, and 97% and 91% specificity for the two nurses (cutoff ≥4).

Conclusion

In a Japanese cardio-surgical ICU, the ICDSC had a higher sensitivity than the CAM-ICU.