Improved detection of delirium, implementation and validation of the CAM-ICU in elderly Emergency Department patients

Evelien K. Van de Meeberg*, Suzanne Festen, Marieke Kwant, Rita R. Georg, Gerbrand J. Izaks, Jan C. ter Maaten

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

21 Citaten (Scopus)
88 Downloads (Pure)


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.

Originele taal-2English
Pagina's (van-tot)411-416
Aantal pagina's6
TijdschriftEuropean Journal of Emergency Medicine
Nummer van het tijdschrift6
StatusPublished - dec.-2017

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