Intensive Care Medicine

, Volume 27, Issue 5, pp 859–864

Intensive Care Delirium Screening Checklist: evaluation of a new screening tool

  • N. Bergeron
  • M.-J. Dubois
  • M. Dumont
  • S. Dial
  • Y. Skrobik
Original

DOI: 10.1007/s001340100909

Cite this article as:
Bergeron, N., Dubois, M., Dumont, M. et al. Intensive Care Med (2001) 27: 859. doi:10.1007/s001340100909

Abstract

Objective: Delirium in the intensive care unit is poorly defined. Clinical evaluation is difficult in the setting of unstable, often intubated patients. A screening tool may improve the detection of delirium. Method: We created a screening checklist of eight items based on DSM criteria and features of delirium: altered level of consciousness, inattention, disorientation, hallucination or delusion, psychomotor agitation or retardation, inappropriate mood or speech, sleep/wake cycle disturbance, and symptom fluctuation. During 3 months, all patients admitted to a busy medical/surgical intensive care unit were evaluated, and the scale score was compared to a psychiatric evaluation. Results: In 93 patients studied, 15 developed delirium. Fourteen (93%) of them had a score of 4 points or more. This score was also present in 15 (19%) of patients without delirium, 14 of whom had a known psychiatric illness, dementia, a structural neurological abnormality or encephalopathy. A ROC analysis was used to determine the sensitivity and specificity of the screening tool. The area under the ROC curve is 0.9017. Predicted sensitivity is 99% and specificity is 64%. Conclusion: This study suggests that the Intensive Care Delirium Screening Checklist can easily be applied by a clinician or a nurse in a busy critical care setting to screen all patients even when communication is compromised. The tool can be utilized quickly and helps to identify delirious patients. Earlier diagnosis may lead to earlier intervention and better patient care.

Delirium Intensive care unit Screening Detection Checklist Rating scale

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • N. Bergeron
    • 1
  • M.-J. Dubois
    • 2
  • M. Dumont
    • 3
  • S. Dial
    • 4
  • Y. Skrobik
    • 5
  1. 1.Department of Psychiatry, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, CanadaCanada
  2. 2.Division of Critical Care, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, CanadaCanada
  3. 3.COREV, affiliated with Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, CanadaCanada
  4. 4.Critical Care and Respirology, McGill University, Montréal, Québec, CanadaCanada
  5. 5.Critical Care, Université de Montréal, Hôpital Maisonneuve-Rosemont, 5415 Boulevard de l'Assomption, Montréal, Québec, Canada H1T 2M4Canada