title: Delirium among critically ill adults: evaluation of the psychometric properties of the Italian 'Confusion Assessment Method for the Intensive Care Unit'.
abstract: OBJECTIVE
  To determine the psychometric properties of the Italian version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), a clinical assessment tool to detect delirium among Intensive Care Unit patients.
  
  
  METHODS
  Validation study.
  
  
  METHODS
  Fifty-seven patients admitted to three medical and surgical Intensive Care Units were recruited. During the study interval two trained examiners performed independent delirium assessment by the CAM-ICU for a maximum of four times per patient.
  
  
  METHODS
  Interrater reliability and internal consistency of the tool, which were measured using Cohen's κ and Cronbach's α coefficients respectively.
  
  
  RESULTS
  Seventy-two paired evaluations were collected. The 35% of the studied cohort tested positive for delirium. The Italian version of the CAM-ICU demonstrated a substantial interrater reliability (κ=0.76, p<0.0001) and a very good internal consistency (α=0.87, 95% confidence interval: 0.81-0.91).
  
  
  CONCLUSIONS
  The Italian CAM-ICU was found to be a viable instrument by which to approach a standardised monitoring of delirium among Italian speaking ICU patients. The use of such tools may facilitate ICU physicians and nurses in detecting delirium, thus improving both quality and safety of care.
authors: Operating Room Unit, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy. Electronic address: gaspardo.pietro@gmail.com.
authors: Pietro
authors: P
authors: Gaspardo
authors: Department of Anesthesiology and Intensive Care, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
authors: Luca
authors: L
authors: Peressoni
authors: Department of Anesthesiology and Intensive Care, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
authors: Irene
authors: I
authors: Comisso
authors: Department of Pathophysiology and Transplantation, University of Milan, Via A. Di Rudinì 8, 20142 Milan, Italy. Electronic address: giovanni.mistraletti@unimi.it.
authors: Giovanni
authors: G
authors: Mistraletti
authors: Division of Allergy, Pulmonary, and Critical Care Medicine in the Department of Medicine, Center for Quality Aging, Center for Health Services Research, Vanderbilt University, Nashville, TN, USA; Geriatric Research, Education and Clinical Center (GRECC) Service at the Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN, USA.
authors: E Wesley
authors: EW
authors: Ely
authors: Department of Rehabilitation and Age Care, Casa di Cura Ancelle della Carità, Via Aselli 16, 26100 Cremona, Italy; Geriatric Research Group, Brescia, Italy. Electronic address: morandi.alessandro@gmail.com.
authors: Alessandro
authors: A
authors: Morandi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000175:diagnosis*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000451:nursing*; D003693:Delirium / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Clinical assessment tools; Cognitive impairment; Critical care; Delirium; Intensive care units; Neurological monitoring