title: The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients.
abstract: OBJECTIVE
  The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units.
  
  
  METHODS
  The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools.
  
  
  RESULTS
  One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96)
  
  
  CONCLUSIONS
  All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients.
authors.affiliation: Intensive Care Unit, University Hospital Prof. Edgar Santos, Universidade Federal da Bahia, Salvador, BA, Brazil. dimitrigusmao@gmail.com
authors.forename: Dimitri
authors.initials: D
authors.lastname: Gusmao-Flores
authors.forename: Jorge Ibrain Figueira
authors.initials: JI
authors.lastname: Salluh
authors.forename: Felipe
authors.initials: F
authors.lastname: Dal-Pizzol
authors.forename: Cristiane
authors.initials: C
authors.lastname: Ritter
authors.forename: Cristiane Damiani
authors.initials: CD
authors.lastname: Tomasi
authors.forename: Marco Antônio Sales Dantas de
authors.initials: MA
authors.lastname: Lima
authors.forename: Lauro Reis
authors.initials: LR
authors.lastname: Santana
authors.forename: Rita Márcia Pacheco
authors.initials: RM
authors.lastname: Lins
authors.forename: Patrícia Pimenta
authors.initials: PP
authors.lastname: Lemos
authors.forename: Gisele Vasconcelos
authors.initials: GV
authors.lastname: Serpa
authors.forename: Jenisson
authors.initials: J
authors.lastname: Oliveira
authors.forename: Ricardo Ávila
authors.initials: RÁ
authors.lastname: Chalhub
authors.forename: Melissa Tassano
authors.initials: MT
authors.lastname: Pitrowsky
authors.forename: Acioly L T
authors.initials: AL
authors.lastname: Lacerda
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.forename: Lucas C
authors.initials: LC
authors.lastname: Quarantini
mesh_terms: D001938:Brazil; D016638:Critical Illness; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007802:Language; D008297:Male; D008403:Mass Screening / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014177:Translations
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