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Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit
INTRODUCTION. Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of deliriu...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lithuanian Academy of Sciences Publishers
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008005/ https://www.ncbi.nlm.nih.gov/pubmed/29928153 http://dx.doi.org/10.6001/actamedica.v25i1.3699 |
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author | Linkaitė, Gabrielė Riauka, Mantas Bunevičiūtė, Ignė Vosylius, Saulius |
author_facet | Linkaitė, Gabrielė Riauka, Mantas Bunevičiūtė, Ignė Vosylius, Saulius |
author_sort | Linkaitė, Gabrielė |
collection | PubMed |
description | INTRODUCTION. Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of delirium. The classification of the patients into groups by risk allows efficient initiation of preventive measures. The goal of this study was to validate the PRE-DELIRIC model using the CAM-ICU (The Confusion Assessment Method for the Intensive Care Unit) method for the diagnosis of delirium. MATERIALS AND METHODS. Patients admitted to the University Hospital of Vilnius during February 2015 were enrolled. Every day, data were collected for APACHE-II and PRE-DELIRIC scores. Out of 167 patients, 38 (23%) were included and screened using the CAM-ICU method within 24 hours of admission to the ICU. We defined patients as having delirium when they had at least one positive CAM-ICU screening or haloperidol administration due to sedation. To validate the PRE-DELIRIC model, we calculated the area under receiver operating characteristic curve. RESULTS. The mean age of the patients was 69.2 ± 17.2 years, 19 (50%) were male, APACHE-II mean score 18.0 ± 7.4 points. Delirium was diagnosed in 22 (58%) of 38 patients. Data used for validation of the PRE-DELIRIC model resulted in an area under the curve of 0.713 (p < 0.05, 95% CI 0.539–0.887); sensitivity and specificity for the patients with 20% risk were, accordingly, 77.3% and 50%; 40% risk – 45.5% and 81.3%, 60% – 36.4%, and 87.5%. CONCLUSIONS. The PRE-DELIRIC model predicted delirium in the patients within 24 hours of admission to the ICU. Preventive therapy could be efficiently targeted at high-risk patients if both of the methods are to be implemented. |
format | Online Article Text |
id | pubmed-6008005 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Lithuanian Academy of Sciences Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-60080052018-06-20 Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit Linkaitė, Gabrielė Riauka, Mantas Bunevičiūtė, Ignė Vosylius, Saulius Acta Med Litu Research Article INTRODUCTION. Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of delirium. The classification of the patients into groups by risk allows efficient initiation of preventive measures. The goal of this study was to validate the PRE-DELIRIC model using the CAM-ICU (The Confusion Assessment Method for the Intensive Care Unit) method for the diagnosis of delirium. MATERIALS AND METHODS. Patients admitted to the University Hospital of Vilnius during February 2015 were enrolled. Every day, data were collected for APACHE-II and PRE-DELIRIC scores. Out of 167 patients, 38 (23%) were included and screened using the CAM-ICU method within 24 hours of admission to the ICU. We defined patients as having delirium when they had at least one positive CAM-ICU screening or haloperidol administration due to sedation. To validate the PRE-DELIRIC model, we calculated the area under receiver operating characteristic curve. RESULTS. The mean age of the patients was 69.2 ± 17.2 years, 19 (50%) were male, APACHE-II mean score 18.0 ± 7.4 points. Delirium was diagnosed in 22 (58%) of 38 patients. Data used for validation of the PRE-DELIRIC model resulted in an area under the curve of 0.713 (p < 0.05, 95% CI 0.539–0.887); sensitivity and specificity for the patients with 20% risk were, accordingly, 77.3% and 50%; 40% risk – 45.5% and 81.3%, 60% – 36.4%, and 87.5%. CONCLUSIONS. The PRE-DELIRIC model predicted delirium in the patients within 24 hours of admission to the ICU. Preventive therapy could be efficiently targeted at high-risk patients if both of the methods are to be implemented. Lithuanian Academy of Sciences Publishers 2018 /pmc/articles/PMC6008005/ /pubmed/29928153 http://dx.doi.org/10.6001/actamedica.v25i1.3699 Text en © Lietuvos mokslų akademija, 2018 |
spellingShingle | Research Article Linkaitė, Gabrielė Riauka, Mantas Bunevičiūtė, Ignė Vosylius, Saulius Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title | Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title_full | Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title_fullStr | Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title_full_unstemmed | Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title_short | Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit |
title_sort | evaluation of pre-deliric (prediction of delirium in icu patients) delirium prediction model for the patients in the intensive care unit |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008005/ https://www.ncbi.nlm.nih.gov/pubmed/29928153 http://dx.doi.org/10.6001/actamedica.v25i1.3699 |
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