Die Intensive Care Delirium Screening Checklist (ICDSC) – Richtlinienkonforme Übersetzung und Validierung einer intensivmedizinischen Delirium–Checkliste

Zusammenfassung

Hintergrund. Das Delirium ist die häufigste psychiatrische Erkrankung im intensivmedizinischen Bereich, dennoch wird es in bis zu 84 % der Fälle nicht oder erst sehr spät erkannt.

Methoden. Übersetzung der ICDSC entsprechend den ISPOR–Richtlinien sowie Validierung in einer Untersuchung von 68 ITS–Patienten.

Ergebnisse. Der Übersetzungsprozess wurde von der Originalautorin autorisiert. Die finale deutsche Übersetzung der ICDSC zeigte eine Sensitivität und Spezifität von 89 % respektive 57 %.

Schlussfolgerung. Die ICDSC bietet sich für das Delirium–Screening durch Pflegekräfte, auch bei beatmeten Patienten, an. Neben einer hohen Sensitivität ist ein weiterer Vorteil die Fähigkeit, auch ein subsyndromales Delirium zu erkennen.

Abstract

Background. Although Delirium is the most common psychiatric disease in ICU settings, it is recognized late or not at all in up to 84 % of all cases.

Methods. Translation of the ICDSC, in accordance with ISPOR guidelines and validation by conducting a screening of 68 ICU patients.

Results. The translation process was autorized by the original author. The final German translation of the ICDSC showed a sensitivity and specificity of 89 % and 57 % respectively.

Conclusion. The ICDSC is suitable for delirium screening by nurses even on ventilated patients. Besides a high sensitivity another advantage is the possibility to screen for a subsyndromal delirium.

Schlüsselwörter:

Delirium - Screening Tool - richtlinienkonforme Übersetzung - ICDSC - Intensivmedizin

Keywords:

Delirium - screening tool - guideline conform translation - ICDSC - Intensive Care

Literatur

• 1 Ely EW, Inouye SK, Bernard GR. et al. . Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM–ICU).  JAMA. 2001;  286 2703-2710
• 2 Ely EW, Siegel MD, Inouye SK.. Delirium in the intensive care unit: an under–recognized syndrome of organ dysfunction.  Semin Respir Crit Care Med. 2001;  22 115-126
• 3 Inouye SK, Bogardus ST, Charpentier PA. et al. . A multicomponent intervention to prevent delirium in hospitalized older patients.  N Engl JMed. 1999;  340 669-676
• 4 Pandharipande P, Jackson J, Ely EW.. Delirium: acute cognitive dysfunction in the critically ill.  Curr Opin Crit Care. 2005;  11 360-368
• 5 American Psychiatric Association. .Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association 1987
• 6 Thomason JW, Shintani A, Peterson JF. et al. . Intensive care unit delirium is an independent predictor of longer hospital stay: a prospective analysis of 261 non–ventilated patients.  Crit Care. 2005;  9
• 7 Ely EW, Gautam S, Margolin R. et al. . The impact of delirium in the intensive care unit on hospital length of stay.  Intensive Care Med. 2001;  27 1892-1900
• 8 Ely EW, Shintani A, Truman B. et al. . Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit.  JAMA. 2004;  291
• 9 Krauseneck T, Seemüller F, Krähenmann O, Schelling G, Padberg F.. Psychiatrische Erkrankungen auf der Intensivstation – Das Delir.  Anasthesiol Intensivmed Notfallmed Schmerzther. 2006;  41 720-726
• 10 Andrew MK, Freter SH, Rockwood K.. Incomplete functional recovery after delirium in elderly people: a prospective cohort study.  BMC Geriatr. 2005;  5 5
• 11 Levkoff SE, Evans DA, Liptzin B, Cleary PD, Lipsitz LA, Wetle TT, Reilly CH, Pilgrim DM, Schor J, Rowe Delirium. J.. The occurrence and persistence of symptoms among elderly hospitalized patients.  Arch Intern Med. 1992;  152 334-340
• 12 McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK.. Delirium in the intensive care unit: occurrence and clinical course in older patients.  J Am Geriatr Soc. 2003;  51 591-598
• 13 McCusker J. et al. . Delirium in older medical inpatients and subsequent cognitive and functional status: a prospective study.  CMAJ. 2001;  165 575-583
• 14 The ICD–10 Classification of Mental and Behavioral Disorder, Diagnostic criteria for research WHO, Geneva 1990; ICD. 10
• 15 American Psychiatric Association. . Practice guideline for the treatment of patients with delirium.  AmJ Psychiatry. 1999;  156 1-20
• 16 Reischies FM, Diefenbacher A.. Delirium in general hospital inpatients: German developments.  Adv Psychosom Med. 2004;  26
• 17 Hasemann W, Kressig W, Ermini–Funfschilling D. et al. . Delirium: screening, assessment and diagnosis.  Pflege. 2007;  20 191-204
• 18 Laurila JV, Pitkala KH, Strandberg TE. et al. . The impact of different diagnostic criteria on prevalence rates for delirium.  Dement Geriatr Cogn Disord. 2003;  16 156-162
• 19 Laurila JV, Pitkala KH, Strandberg TE. et al. . Impact of different diagnostic criteria on prognosis of delirium: a prospective study.  Dement Geriatr Cogn Disord. 2004;  18
• 20 Burns A, Gallagley A, Byrne J.. Delirium.  J Neurol Neurosurg Psychiatry. 2004;  75 362-367
• 21 Peterson JF, Pun BT, Dittus RS. et al. . Delirium and its motoric subtypes: a study of 614 critically ill patients.  J Am Geriatr Soc. 2006;  54 479-484
• 22 Liptzin B, Levkoff SE.. An empirical study of delirium subtypes.  Br J Psychiatry. 1992;  161 843-845
• 23 Meagher DJ, O'Hanlon D, O'Mahony E. et al. . Relationship between symptoms and motoric subtype of delirium.  J Neuropsychiatry Clin Neurosci. 2000;  12 51-56
• 24 Francis J, Martin D, Kapoor WN.. A prospective study of delirium in hospitalized elderly.  JAMA. 1990;  263 1097-1101
• 25 Inouye SK.. The dilemma of delirium: clinical and research controversies regarding diagnosis and evaluation of delirium in hospitalized elderly medical patients.  Am J Med. 1994;  97 278-288
• 26 Inouye SK, Foreman MD, Mion LC. et al. . Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings.  Arch Intern Med. 2001;  161 2467-2473
• 27 O'Keeffe ST.. Clinical subtypes of delirium in the elderly.  Dement Geriatr Cogn Disord. 1999;  10 380-385
• 28 O'Keeffe ST, Lavan JN.. Clinical significance of delirium subtypes in older people.  Age Ageing. 1999;  28 115-119
• 29 Ely EW, Stephens RK, Jackson JC. et al. . Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: a survey of 912 healthcare professionals.  Crit Care Med. 2004;  32 106-112
• 30 Jacobi J, Fraser GL, Coursin DB. et al. . Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult.  Crit Care Med. 2002;  30 119-141
• 31 Martin J, Bürkle H, Hommel J. et al. . Analgesie und Sedierung in der Intensivmedizin – S2–Leitlinien der Gesellschaft für Anästhesiologie und Intensivmedizin.  Anästh Intensivmed. 2005;  46 1-20
• 32 Devlin JW, Fong JJ, Schumaker G, O'Connor H, Ruthazer R, Garpestad E.. Use of a validated delirium assessment tool improves the ability of physicians to identify delirium in medical intensive care unit patients.  Crit Care Med. 2007;  35 2721-2724
• 33 Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y.. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool.  Intensive Care Med. 2001;  27 859-864
• 34 Ouimet S. et al. . Subsyndromal delirium in the ICU: evidence for a disease spectrum.  Intensive Care Med. 2007;  33 1007-1013
• 35 Wild D, Grove A, Martin M. et al. . Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient–Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation.  Value Health. 2005;  8 94-104
• 36 Marcantonio ER, Goldman L, Mangione CM. et al. . A clinical prediction rule for delirium after elective noncardiac surgery.  JAMA. 1994;  271 134-139
• 37 Smith MJ, Breitbart WS, Platt MM.. A critique of instruments and methods to detect, diagnose, and rate delirium.  J Pain Symptom Manage. 1995;  10 35-77
• 38 Schuurmans MJ, Duursma SA, Shortridge–Baggett LM.. Early recognition of delirium: review of the literature.  J Clin Nurs. 2001;  10 721-729
• 39 Pun BT, Gordon SM, Peterson JF. et al. . Large–scale implementation of sedation and delirium monitoring in the intensive care unit: a report from two medical centers.  Crit Care Med. 2005;  33 1199-1205
• 40 Gaudreau JD, Gagnon P, Harel F. et al. . Impact on delirium detection of using a sensitive instrument integrated into clinical practice.  Gen Hosp Psychiatry. 2005;  27 194-199
• 41 Dubois MJ, Bergeron N, Dumont M. et al. . Delirium in an intensive care unit: a study of risk factors.  Intensive Care Med. 2001;  27 1297-1304
• 42 Marcantonio ER, Kiely DK, Simon SE. et al. . Outcomes of older people admitted to postacute facilities with delirium.  J Am Geriatr Soc. 2005;  53 963-969