title: [Confusion Assessment Method for diagnosing delirium in ICU patients (CAM-ICU): cultural adaptation and validation of the Spanish version].
abstract: To adapt the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium to the language and culture of Spain and to validate the adapted version.
  
  
  
  Population validation.
  
  
  
  Intensive care units in a 600-bed university hospital.
  
  
  
  We studied 29 critical patients undergoing mechanical ventilation. Mean age was 70 years (range 58-77 years), mean APACHE II score 16 (range 13-21), and mean SOFA score 7 (range 4-8).
  
  
  
  Two independent operators applied the Spanish version of the CAM-ICU and a psychiatrist applied the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-Revised (DSM IV TR).
  
  
  
  Concordance (kappa index), internal consistency (Cronbach's alpha), and validity (sensitivity and specificity) of the Spanish version of the CAM-ICU were compared to the DSM IV TR, which is considered the current gold standard.
  
  
  
  The translation and cultural adaptation was carried out in accordance with current international guidelines. A total of 65 assessments were performed in 29 patients. The interobserver concordance was high: kappa statistic 0.91 (95% CI: 0.86-0.96). The internal consistence was adequate: Cronbach's alpha=0.84 (unilateral 95% CI: 0.77). For observer A (a physician), the sensitivity of the Spanish version of the CAM-ICU was 80% and the specificity was 96%. For observer B, (a nurse) the sensitivity was 83% and the specificity was 96%.
  
  
  
  The Spanish version of the CAM-ICU is a valid, reliable, and reproducible instrument that can be satisfactorily applied to diagnose delirium in Spanish-speaking ICU patients.
authors.affiliation: Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Chile.
authors.forename: E
authors.initials: E
authors.lastname: Tobar
authors.forename: C
authors.initials: C
authors.lastname: Romero
authors.forename: T
authors.initials: T
authors.lastname: Galleguillos
authors.forename: P
authors.initials: P
authors.lastname: Fuentes
authors.forename: R
authors.initials: R
authors.lastname: Cornejo
authors.forename: M T
authors.initials: MT
authors.lastname: Lira
authors.forename: L
authors.initials: L
authors.lastname: de la Barrera
authors.forename: J E
authors.initials: JE
authors.lastname: Sánchez
authors.forename: F
authors.initials: F
authors.lastname: Bozán
authors.forename: G
authors.initials: G
authors.lastname: Bugedo
authors.forename: A
authors.initials: A
authors.lastname: Morandi
authors.forename: Wesley E
authors.initials: WE
authors.lastname: Ely
mesh_terms: D018806:APACHE; D000368:Aged; D001288:Attention; D002677:Chile / Q000453:epidemiology; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000523:psychology*; D003469:Culture; D003693:Delirium / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007802:Language; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010348:Patient Care Team; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index