Cent Eur J Nurs Midw 2022, 13(1):587-594 | DOI: 10.15452/cejnm.2021.12.0033

Comparing the CAM-ICU and ICDSC for assessing delirium in non-intubated intensive care patients

Hana Locihová1,2,3, Karel Axmann4
1 Department of Intensive Medicine, Emergency Medicine and Forensic Studies, Faculty of Medicine, University of Ostrava, Czech Republic
2 AGEL Educational and Research Institute (VIA), Prostějov, Czech Republic
3 AGEL Secondary Nursing School and Higher Nursing School, Ostrava, Czech Republic
4 Department of Anaesthesiology and Resuscitation and Intensive Care Medicine, University Hospital Olomouc, Czech Republic

Aim: The study compared two instruments for detecting delirium, the Intensive Care Delirium Screening Checklist (ICDSC) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) as a reference method.

Design: Prospective observational study.

Methods: The study included 126 consecutive patients staying in the intensive care unit (ICU) for more than 24 hours. The diagnostic properties of both questionnaires and agreement between them were studied and compared. Additionally, the two tests were used to assess the relationship between selected patient parameters and the presence of delirium. Results: There was a high level of agreement between the CAM-ICU and ICDSC, as expressed by Cohen’s κ of 0.829 (95% CI: 0.821–0.838). Cronbach’s α assessing the internal consistency of a Czech version of the CAM-ICU and ICDSC was 0.903 and 0.865, respectively. The CAM-ICU had 85.5% sensitivity (95% CI: 84.6–91.8) and 94.1% specificity (95% CI: 92.4–95.5); the ICDSC (cut-off ≥ 4) had 90.6% sensitivity (95% CI: 87.0–93.5) and 89.0% specificity (95% CI: 86.8–91.0).

Conclusion: Both compared diagnostic instruments, the CAM-ICU and ICDSC, appear to be adequate and usable. When compared with the CAM-ICU as a reference method, the ICDSC showed similar results and a good level of agreement.

Keywords: Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), delirium, Intensive Care Delirium Screening Checklist (ICDSC), intensive care unit (ICU)

Received: May 14, 2021; Revised: November 1, 2021; Accepted: November 1, 2021; Prepublished online: February 21, 2022; Published: March 5, 2022  Show citation

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Locihová H, Axmann K. Comparing the CAM-ICU and ICDSC for assessing delirium in non-intubated intensive care patients. Central European Journal of Nursing and Midwifery. 2022;13(1):587-594. doi: 10.15452/cejnm.2021.12.0033.
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