BioSpace Collaborative

Academic/Biomedical Research
News & Jobs
Biotechnology and Pharmaceutical Channel Medical Device and Diagnostics Channel Clinical Research Channel BioSpace Collaborative    Job Seekers:  Register | Login          Employers:  Register | Login  

NEWSLETTERS
Free Newsletters
Archive
My Subscriptions

NEWS
News by Subject
News by Disease
News by Date
PLoS
Search News
Post Your News
JoVE

CAREER NETWORK
Job Seeker Login
Most Recent Jobs
Search Jobs
Post Resume
Career Fairs
Career Resources
For Employers

HOTBEDS
Regional News
US & Canada
  Biotech Bay
  Biotech Beach
  Genetown
  Pharm Country
  BioCapital
  BioMidwest
  Bio NC
  BioForest
  Southern Pharm
  BioCanada East
  C2C Services & Suppliers™
Europe
Asia

DIVERSITY

PROFILES
Company Profiles

INTELLIGENCE
Research Store

INDUSTRY EVENTS
Research Events
Post an Event
RESOURCES
Real Estate
Business Opportunities

PLoS By Category | Recent PLoS Articles
Critical Care and Emergency Medicine - Mental Health - Neurological Disorders - Public Health and Epidemiology

CAM-ICU and ICDSC Agreement in Medical and Surgical ICU Patients Is Influenced by Disease Severity
Published: Friday, November 30, 2012
Author: Jorge Alberto de Oliveira Fagundes et al.

by Jorge Alberto de Oliveira Fagundes, Cristiane Damiani Tomasi, Vinicius Rene Giombelli, Sarah Cascaes Alves, Roberta Candal de Macedo, Maria Fernanda Locks Topanotti, Maria de Lourdes Ugioni Bristot, Pedro Emmanuel Alvarenga Americano do Brasil, Márcio Soares, Jorge Salluh, Felipe Dal-Pizzol, Cristiane Ritter

Introduction

Delirium is a prevalent condition in patients admitted to intensive care units (ICU) associated with worse outcomes. The principal aim of the present study was compare the agreement between two tools for delirium assessment in medical and surgical patients admitted to the ICU.

Methods

Consecutive adult surgical and medical patients admitted to the ICU for more than 24 hours between March 2009 and September 2010 were included. Delirium was evaluated twice a day using the Intensive Care Delirium Screening Checklist (ICDSC) and Confusion Assessment Method adapted to the Intensive Care Unit (CAM-ICU). The kappa (k) and AC1 coefficients were calculated as a measure of agreement between the CAM-ICU and ICDSC.

Results

A total of 595 patients were enrolled in the study. There were 69 (12%) emergency surgical, 207 (35%) elective surgical and 319 (54%) medical patients. Delirium incidence evaluated by the ICDSC, but not by the CAM-ICU, was similar among the three groups. Overall agreement between CAM-ICU and ICDSC was moderate (k?=?0.5) to substantial (AC1?=?0.71). In medical patients the agreement between the two instruments was moderate (k?=?0.53) to substantial (AC1?=?0.76). The agreement between the two tools in emergency surgical patients was also moderate (k?=?0.53) to substantial (AC1?=?0.68). In elective surgical patients the agreement between the two instruments was low (k?=?0.42) to substantial (AC1?=?0.74).Agreement rates seemed to be influenced by disease severity. The agreement rate in the general ICU population with APACHE II?=?<14 was k?=?0.57 and AC1?=?0.81, compared to k?=?0.44 and AC1?=?0.59, in patients with more severe disease. This was even more different when the need for mechanical ventilation was used as a surrogate of disease severity.

Conclusions

The agreement rates between CAM-ICU and ICDSC may vary between different groups of ICU patients and seems to be affected by disease severity.

  More...