Delirium rating scales in critically ill patients: a systematic literature review

Rev Bras Ter Intensiva. 2013 Apr-Jun;25(2):148-54. doi: 10.5935/0103-507X.20130026.
[Article in English, Portuguese]

Abstract

Objective: To identify scales that can establish a quantitative assessment of delirium symptoms in critically ill patients through a systematic review.

Methods: Studies that evaluated delirium stratification scales in patients hospitalized in intensive care units were selected in a search performed in the MedLine database. Validation studies of these scales and their target patient populations were analyzed, and we identified the examiner and the signs and symptoms evaluated. In addition, the duration of the application and the sensitivity and specificity of each scale were assessed.

Results: Six scales were identified: the Delirium Detection Score, the Cognitive Test of Delirium, the Memorial Delirium Assessment Scale, the Intensive Care Delirium Screening Checklist, The Neelon and Champagne Confusion Scale and the Delirium Rating Scale-Revised-98.

Conclusion: The scales identified allow the stratification and monitoring of critically ill patients with delirium. Among the six scales, the most studied and best suited for use in the intensive care units was the Intensive Care Delirium Screening.

Objetivo: Identificar escalas capazes de estabelecer uma avaliação quantitativa dos sintomas do delirium em pacientes graves por meio de uma revisão sistemática.

Métodos: Foram selecionados estudos que avaliaram escalas de estratificação de delirium em pacientes internados em unidades de terapia intensiva a partir de busca na base de dados MedLine. Os estudos de validação dessas escalas foram analisados, e foram identificados os pacientes alvos para aplicação, o avaliador, os sinais e sintomas avaliados, a duração da aplicação, além da sensibilidade e da especificidade de cada escala.

Resultados: Seis escalas foram identificadas: o Delirium Detection Score, o Cognitive Test of Delirium, a Memorial Delirium Assessment Scale, o Intensive Care Delirium Screening Checklist, a The Neelon and Champagne Confusion Scale e a Delirium Rating Scale-Revised-98.

Conclusão: As escalas identificadas permitem estratificação e acompanhamento do paciente grave com delirium. Dentre as seis escalas, a mais estudada e que melhor se adequa ao uso em unidade de terapia intensiva foi o Intensive Care Delirium Screening Checklist.

Publication types

  • Comparative Study
  • Review
  • Systematic Review

MeSH terms

  • Checklist
  • Critical Care / methods*
  • Critical Illness
  • Delirium / diagnosis*
  • Humans
  • Intensive Care Units*
  • Psychiatric Status Rating Scales
  • Sensitivity and Specificity