Clinics (Jan 2011)

The validity and reliability of the portuguese versions of three tools used to diagnose delirium in critically ill patients

  • Dimitri Gusmao-Flores,
  • Jorge Ibrain Figueira Salluh,
  • Felipe Dal-Pizzol,
  • Cristiane Ritter,
  • Cristiane Damiani Tomasi,
  • Marco Antônio Sales Dantas de Lima,
  • Lauro Reis Santana,
  • Rita Márcia Pacheco Lins,
  • Patrícia Pimenta Lemos,
  • Gisele Vasconcelos Serpa,
  • Jenisson Oliveira,
  • Ricardo Ávila Chalhub,
  • Melissa Tassano Pitrowsky,
  • Acioly L.T Lacerda,
  • Karestan C Koenen,
  • Lucas C Quarantini

DOI
https://doi.org/10.1590/S1807-59322011001100011
Journal volume & issue
Vol. 66, no. 11
pp. 1917 – 1922

Abstract

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OBJECTIVES: The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units. METHODS: The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools. RESULTS: One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96) CONCLUSION: All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients.

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