Evaluation of Delirium in Postoperative Patients

• Autor(a) principal: Abelha,Fernando José
• Data de Publicação: 2010
• Outros Autores: Botelho,Miguela, Fernandes,Vera, Santos,Alice, Dias,Isabel, Barros,Henrique
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0871-34132010000400001
• topic: postoperative; delirium; intensive care; outcome

Background: Postoperative delirium is associated with increased length of stay, both in hospital and in the Post Anesthesia Care Unit (PACU), more frequent medical complications, and increased mortality. Intensive Care Delirium Screening Checklist (ICDSC) score of 4 or more correlates well with a psychiatrist’s clinical diagnosis of delirium with an excellent interobserver reliability between nurses and critical care physicians. The aim of this study was to translate, retranslate and validate ICDSC for use in Portuguese PACU settings. Methods: The translation of the ICDSC was done according to the guidelines suggested by The Translation and Cultural Adaption. For the validation process we have prospectively studied its applicability in a prospective study carried out, during 1 month period, in a PACU with five intensive care beds. Research staff physicians and nurses prospectively performed daily evaluation of each patient once per day using ICDSC. Interrater reliability was calculated using kappa statistics. Results: Research staff physicians and nurses studied 79 patients eligible for the scale rating. We did record 107 paired observations. Nine (11.4%) patients were diagnosed as having delirium by both research staff physicians and nurses. In the 107 paired observations, overall interrater reliability was very good between nurses and the research staff physician (Kappa statistics ranged 0.790 to 0.933). Conclusion: The translation of the ICDSC showed good correlation with the original version and could therefore be applicable in Portuguese PACU settings. The interrater variability was very good and this translated version of ICDSC was suitable for delirium screening by nurses and physicians.