[Confusion Assessment Method for diagnosing delirium in ICU patients (CAM-ICU): cultural adaptation and validation of the Spanish version].
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.
Tobar
E
E
Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Chile.
Romero
C
C
Galleguillos
T
T
Fuentes
P
P
Cornejo
R
R
Lira
M T
MT
de la Barrera
L
L
Sánchez
J E
JE
Bozán
F
F
Bugedo
G
G
Morandi
A
A
Ely
Wesley E
WE
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