Delirium detection in stroke patients - Reply
| Authors | |
|---|---|
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Critical Care Medicine |
| MU Faculty or unit | |
| Citation | |
| Web | http://journals.lww.com/ccmjournal/Citation/2012/07000/Delirium_detection_in_stroke_patients.59.aspx |
| Doi | http://dx.doi.org/10.1097/CCM.0b013e3182515042 |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | delirium; stroke; sensitivity; specificity |
| Description | The autors evaluated the test characteristics of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in a consecutive series of 129 stroke patients, and found a sensitivity of 76%, specificity of 98%, and overall accuracy of 94% (95% CI 88% to 97%) as compared with the reference standard DSM IV rater for diagnosing delirium. The challenge in this cohort was the presence of a fresh stroke an added comorbidity in each patient. The authors found the data very affirming that indeed non-psychiatrists have a tool which, if performed according to the Training Manual (www.icudelirium.org) will provide valid and reliable data about the presence or absence of delirium in stroke patients. While they do not believe that this instrument replaces a full neurologic or psychiatric consultation in all patients, they do believe that these data address a driving unmet need of interdisciplinary teams as a way forward in which “non-delirium experts” may proceed to implement delirium evaluations in routine practice. Sensitivity of any brief tool might be influenced by many factors such as education and training of the rater and might be lower compared with research settings. With appropriate implementation science and teamwork, the authors have achieved very high sensitivity and specificity in clinical practice across many ICU types. |
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