• 作者：A.C. Toro^a ; L.M. Escobar^a ; J.G. Franco^a ; ^b ; ^{josefranco11@hotmail.com} ; J.L. Dí ; az-G&#243 ; mez^c ; J.F. Muñ ; oz^a ; F. Molina^c ; J. Bejarano^c ; D. Yepes^c ; E. Navarro^c ; A. Garcí ; a^c ; E. Wesley Ely^d ; A. Esteban^e
• 关键词：Delirio ; Unidades de cuidados intensivos ; Ventilació ; n mecá ; nica ; Sensibilidad y especificidad ; Estudios de validació ; n
• 刊名：Medicina Intensiva
• 出版年：2010
• 期刊代码：pca255_02105691
• 类别：med
• 出版时间：January-February 2010
• 卷：34
• 期：1
• 页码：14-21
• 文件大小：219 K

Objective

To validate the Spanish version of the CAM-ICU.

Design

Validation study. The inter-rater reliability and validity were evaluated using a blind comparison with the DSM-IVTR criteria (reference standard) in a group of patients hospitalized in an Intensive Care Unit (ICU).

Setting

Medical-surgical ICU.

Patients

129 adults with RASS >鈭? score, within the 24鈥?8 h of ICU admission. Independent application of the CAM-ICU by two intensive care specialists and evaluation by a psychiatrist using the DSM-IVTR criteria for delirium.

Results

Prevalence of delirium in the sample was 26.4%, this being and 48.3%in the 29 patients who received mechanical ventilation. Inter-rater reliability in the whole sample according to the Kappa index was 0.792 (95%CI 0.662鈥?.922, p<0.001) and in those who received mechanical ventilation was 0.726 (95%CI 0.487鈥?.965, p<0.001). The sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (鈭扡R) were 79.4%(95%CI 63.2鈥?9.7%); 97.9%(95%CI 92.6鈥?9.4%); 93.1%(95%CI 78.0鈥?8.1%); 93.0%(95%CI 86.3鈥?6.6%); 37.72 (95%CI 9.47鈥?50.20) and 0.21(95%CI 0.11鈥?.41), respectively, in the whole sample. In mechanically-ventilated patients, sensitivity, specificity, PPV, NPV, +LR and 鈭扡R were 92.9%(95%CI 68.5鈥?8.7%); 86.7%(95%CI 62.1鈥?6.3%); 86.7%(95%CI 62.1鈥?6.3%); 92.9%(95%CI 68.5鈥?8.7%); 6.96(95%CI 1.90鈥?5.51) and 0.08 (95%CI 0.01鈥?.55), respectively.

Conclusion

The Spanish version of the CAM-ICU is reliable. Its sensitivity, specificity and predictive values should be considered good.