ICU-delirium assessed by CAM-ICU and validated by interview

Abstract

The aim of this study was to translate the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) into Danish and then to use it in clinical practice in order to identify delirium. Additionally, patients tested with the CAM-ICU were interviewed after discharge from hospital in order to validate the tool using semi-structured qualitative interviews. Adult patients in three intensive care units were scored 48 hours after admission to the intensive care unit and then twice a day until discharge. Excluded were patients with central nervous system injuries, psychoses at admission or non-Danish-speaking. The author, who was blinded for the CAM-ICU scores, interviewed ten patients. Following transcription the interviews were content analysed. Four patients were scored by the CAM-ICU to have delirium, and it was confirmed at interview following discharge from intensive care they had all experienced delirium. Six patients were scored negative to delirium; four of these had not experienced delirium but in two cases the patients stated that they had experienced delirium. It is concluded that the CAM-ICU indentifies delirium, but false negative results are possible. Although only a small study, it is concluded that the CAM-ICU is valid and can be used in intervention studies.