Katsuji Nishimura1, Kanako Yokoyama2, Noriko Yamauchi3, Masako Koizumi3, Nozomi Harasawa4, Taeko Yasuda3, Chizuru Mimura3, Hazuki Igita4, Eriko Suzuki2, Yoko Uchiide2, Yusuke Seino5, Minoru Nomura5, Kenji Yamazaki6, Jun Ishigooka2. 1. Department of Psychiatry, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Electronic address: nishimura.katsuji@twmu.ac.jp. 2. Department of Psychiatry, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. 3. Department of Nursing, Tokyo Women's Medical University Hospital, Tokyo, Japan. 4. Tokyo Women's Medical University School of Nursing, Tokyo, Japan. 5. Department of Anaesthesiology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. 6. Department of Cardiovascular Surgery, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
Abstract
OBJECTIVE: 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.
OBJECTIVE: 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.
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