Accuracy of delirium assessments in critically ill children: A prospective, observational study during routine care

Objectives The objectives of this study was to explore the accuracy Cornell Assessment for Pediatric Delirium (CAP-D), Confusion Method Intensive Care Unit (pCAM-ICU), and Preschool (psCAM-ICU) when implemented in routine care as delirium screening tools, assess patient characteristics clinical variables that may affect their validity. Design This is a prospective observational study. Setting conducted 36-bed, mixed paediatric intensive unit (PICU) at an Australian tertiary hospital. Patients included critically ill children developmentally aged 6 months 17 years, with PICU length stay >18 h. Interventions No interventions were provided Measurements main results screened by bedside nurse (CAP-D pCAM-ICU/psCAM-ICU) once daily, up 5 d. status identified using instruments compared diagnosis diagnostic criteria (Diagnostic Statistical Manual Mental Disorders, 5th Edition). In sample, CAP-D retained its high sensitivity (91.3%) good specificity (75.2%), whereas psCAM-ICU pCAM-ICU had moderate (58.8% 75.0%, respectively) excellent (89.8% 84.9%, respectively). There agreement between (? = 0.52, p < .001) 0.80, .01). Conclusions Although CAP-D, psCAM-ICU, all appear promising validation studies, care, performance can be variable. performed well practice, but follow-up required confirm delirium. both provide valuable, objective assessments children; however, further evaluation implementation practice needed.