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The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients
Authors:Gusmao-Flores Dimitri  Salluh Jorge Ibrain Figueira  Dal-Pizzol Felipe  Ritter Cristiane  Tomasi Cristiane Damiani  Lima Marco Antônio Sales Dantas de  Santana Lauro Reis  Lins Rita Márcia Pacheco  Lemos Patrícia Pimenta  Serpa Gisele Vasconcelos  Oliveira Jenisson  Chalhub Ricardo Ávila  Pitrowsky Melissa Tassano  Lacerda Acioly L T  Koenen Karestan C  Quarantini Lucas C
Affiliation:Intensive Care Unit, University Hospital Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, BA, Brazil. dimitrigusmao@gmail.com
Abstract:

OBJECTIVES:

The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units.

METHODS:

The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools.

RESULTS:

One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96).

CONCLUSION:

All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients.
Keywords:CAM-ICU   ICDSC   CAM-ICU Flowsheet   Critical care   Delirium
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