[Spanish version of the CAM-ICU (Confusion Assessment Method for the Intensive Care Unit). Pilot study of validation].
To validate the Spanish version of the CAM-ICU.



Validation study. The inter-rater reliability and validity were evaluated using a blind comparison with the DSM-IVTR criteria (reference standard) in a group of patients hospitalized in an Intensive Care Unit (ICU).



Medical-surgical ICU.



129 adults with RASS >-4 score, within the 24-48 h of ICU admission. Independent application of the CAM-ICU by two intensive care specialists and evaluation by a psychiatrist using the DSM-IVTR criteria for delirium.



Prevalence of delirium in the sample was 26.4%, this being and 48.3% in the 29 patients who received mechanical ventilation. Inter-rater reliability in the whole sample according to the Kappa index was 0.792 (95% CI 0.662-0.922, p<0.001) and in those who received mechanical ventilation was 0.726 (95% CI 0.487-0.965, p<0.001). The sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were 79.4% (95% CI 63.2-89.7%); 97.9% (95% CI 92.6-99.4%); 93.1% (95% CI 78.0-98.1%); 93.0% (95% CI 86.3-96.6%); 37.72 (95% CI 9.47-150.20) and 0.21(95% CI 0.11-0.41), respectively, in the whole sample. In mechanically-ventilated patients, sensitivity, specificity, PPV, NPV, +LR and -LR were 92.9% (95% CI 68.5-98.7%); 86.7% (95% CI 62.1-96.3%); 86.7% (95% CI 62.1-96.3%); 92.9% (95% CI 68.5-98.7%); 6.96(95% CI 1.90-25.51) and 0.08 (95% CI 0.01-0.55), respectively.



The Spanish version of the CAM-ICU is reliable. Its sensitivity, specificity and predictive values should be considered good.
Grupo de Investigación en Psiquiatría de Enlace, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia.
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Toro
L M
LM
Escobar
J G
JG
Franco
J L
JL
Díaz-Gómez
J F
JF
Muñoz
F
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Molina
J
J
Bejarano
D
D
Yepes
E
E
Navarro
A
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García
Wesley E
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Ely
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Esteban
D000328:Adult; D000368:Aged; D003105:Colombia / Q000453:epidemiology; D003128:Coma / Q000175:diagnosis; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000523:psychology*; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method
Versión en español del método para la evaluación de la confusión en cuidados intensivos, estudio piloto de validación.