Abstract
Objective To evaluate the effect of routine use of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) on the diagnosis rate of delirium in elderly Emergency Department (ED) patients and the validity of the CAM-ICU in the ED setting.
Methods This was a prospective observational study in a tertiary care academic ED. We compared the diagnosis rate of delirium before implementation of the CAM-ICU, without routine use of a screening tool, with the diagnosis rate after implementation of the CAM-ICU. All consecutive patients aged 70 years or older were enrolled. The diagnosis rate before implementation was based on chart review and after implementation on a positive CAM-ICU score. In a subsample, the presence of delirium was evaluated independently according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision (DSM-IV-TR) criteria to assess the validity of the CAM-ICU.
Results The total study population included 968 patients: 490 before and 478 after implementation of the CAM-ICU. The two groups were not significantly different in patient characteristics. Before implementation of the CAM-ICU, delirium was diagnosed in 14 patients (3%) and after implementation in 48 patients (10%) (P
Conclusion The diagnosis rate of delirium after implementation of the CAM-ICU was three-fold higher than before. The CAM-ICU is a reliable screening tool in the ED, with high sensitivity, specificity, and positive and negative predictive value. Copyright (c) 2017 Wolters Kluwer Health, Inc. All rights reserved.
Original language | English |
---|---|
Pages (from-to) | 411-416 |
Number of pages | 6 |
Journal | European Journal of Emergency Medicine |
Volume | 24 |
Issue number | 6 |
DOIs | |
Publication status | Published - Dec-2017 |
Keywords
- CAM-ICU
- delirium
- Diagnostic and Statistical Manual of Mental Disorders
- Emergency Department
- validation
- CONFUSION ASSESSMENT METHOD
- INTENSIVE-CARE-UNIT
- MENTAL STATUS
- MORTALITY
- PREVALENCE
- STAY
- RISK
- TOOL