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[Delirium on intensive care frequently missed: clinical impression alone is not enough].
Ned Tijdschr Geneeskd. 2010; 154:A1290.NT

Abstract

OBJECTIVE

To compare the sensitivity and specificity of a routine assessment (clinical impression) with a structured assessment which uses a validated assessment scale for the recognition of delirium on the intensive care unit (ICU).

DESIGN

Observational study.

METHOD

During their admission to the intensive care unit, 103 patients were assessed daily (with a maximum of 40 days) for the presence of delirium using the Confusion assessment method for the intensive care unit (CAM-ICU). Their physicians indicated whether or not they considered the patient delirious. These findings were compared. For all patients daily information was also collected about fixation and complications, such as self-extubation or self-removal of catheters.

RESULTS

The patients were assessed for a period of 502 patient-days. CAM-ICU scores were positive (n = 108), negative (n = 235) or non-assessable because the patient was comatosed or deeply sedated (n = 159). The sensitivity of clinical detection by the physicians was 45% in comparison to the CAM-ICU. The specificity was high (97%).

CONCLUSION

The diagnosis delirium is frequently missed on the ICU when only based on clinical impression. Routine assessment using a validated assessment scale such as the CAM-ICU might possibly improve this.

Authors+Show Affiliations

St. Elisabeth Ziekenhuis, Afd. Psychiatrie, Tilburg, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

dut

PubMed ID

20699025

Citation

van Eck van der Sluijs, Jonna F., et al. "[Delirium On Intensive Care Frequently Missed: Clinical Impression Alone Is Not Enough]." Nederlands Tijdschrift Voor Geneeskunde, vol. 154, 2010, pp. A1290.
van Eck van der Sluijs JF, Oldenbeuving AW, Roks G, et al. [Delirium on intensive care frequently missed: clinical impression alone is not enough]. Ned Tijdschr Geneeskd. 2010;154:A1290.
van Eck van der Sluijs, J. F., Oldenbeuving, A. W., Roks, G., & Tilanus, J. J. (2010). [Delirium on intensive care frequently missed: clinical impression alone is not enough]. Nederlands Tijdschrift Voor Geneeskunde, 154, A1290.
van Eck van der Sluijs JF, et al. [Delirium On Intensive Care Frequently Missed: Clinical Impression Alone Is Not Enough]. Ned Tijdschr Geneeskd. 2010;154:A1290. PubMed PMID: 20699025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Delirium on intensive care frequently missed: clinical impression alone is not enough]. AU - van Eck van der Sluijs,Jonna F, AU - Oldenbeuving,Annemarie W, AU - Roks,Gerwin, AU - Tilanus,Joachim J D, PY - 2010/8/12/entrez PY - 2010/8/12/pubmed PY - 2010/9/18/medline SP - A1290 EP - A1290 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 154 N2 - OBJECTIVE: To compare the sensitivity and specificity of a routine assessment (clinical impression) with a structured assessment which uses a validated assessment scale for the recognition of delirium on the intensive care unit (ICU). DESIGN: Observational study. METHOD: During their admission to the intensive care unit, 103 patients were assessed daily (with a maximum of 40 days) for the presence of delirium using the Confusion assessment method for the intensive care unit (CAM-ICU). Their physicians indicated whether or not they considered the patient delirious. These findings were compared. For all patients daily information was also collected about fixation and complications, such as self-extubation or self-removal of catheters. RESULTS: The patients were assessed for a period of 502 patient-days. CAM-ICU scores were positive (n = 108), negative (n = 235) or non-assessable because the patient was comatosed or deeply sedated (n = 159). The sensitivity of clinical detection by the physicians was 45% in comparison to the CAM-ICU. The specificity was high (97%). CONCLUSION: The diagnosis delirium is frequently missed on the ICU when only based on clinical impression. Routine assessment using a validated assessment scale such as the CAM-ICU might possibly improve this. SN - 1876-8784 UR - https://www.unboundmedicine.com/medline/citation/20699025/[Delirium_on_intensive_care_frequently_missed:_clinical_impression_alone_is_not_enough]_ L2 - https://www.ntvg.nl/A1290 DB - PRIME DP - Unbound Medicine ER -