Yoǧun bakim ünitesinde konfüzyon deǧerlendirme ölçeǧinin geçerlik güvenilirlik çalişmasi

Aim: Delirium is a serious problem, common in the intensive care units (ICU), and is associated with significant morbidity and increased mortality. The Confusion Assessment Method for The ICU (CAM-ICU) was developed as a means by which non-psychiatrists such as ICU nurses or intensivists may diagnose delirium. This study was desined to evaluate the reliability and validity of a Turkish version of the CAM-ICU (YBU-KDO) to identify delirium in the ICU patients. Materials and Methods: Sixty patients with ICU stays > 48 hours studied. The ICU nurse and the intensivist performed independent "YBU-KDO" ratings. "YBU-KDO" has four features: an acute onset of mental status changes or fluctuating course, inattention, disorganized thinking and an altered level of consciousness. The patient is diagnosed as delirious when the first two features and either feature 3 or 4. are present in addition an independent evaluation for delirium was performed by psychiatrist Results: Delirium was diagnosed in 26 (43%) patients. Delirious patients were older, more commonly had prior ICU admissions or were emergency admissiona and had longer ICU stays compared to non-delirious patients. In "YBU-KDO" only verbal attention test was applied and increasing the cut-off value from 8 to 12 increased the agreement. This form of "YBU-KDO" had acceptable sensitivity (65-69%), excellent specificity (97%) and reliability (kappa=0.96). Conclusion: Inclusion of "YBU-KDO" into daily charts would allow early diagnosis, implementation of preventive measures and the treatment of delirium in the ICU.