Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Apr-Jun;25(2):148-54.
doi: 10.5935/0103-507X.20130026.

Delirium rating scales in critically ill patients: a systematic literature review

[Article in English, Portuguese]
João Pedro Lins Mendes Carvalho  1 , Antônio Raimundo Pinto de Almeida, Dimitri Gusmao-Flores
Affiliations
Comparative Study

Delirium rating scales in critically ill patients: a systematic literature review

[Article in English, Portuguese]
João Pedro Lins Mendes Carvalho et al. Rev Bras Ter Intensiva. 2013 Apr-Jun.

Abstract
in English, Portuguese

Objective: To identify scales that can establish a quantitative assessment of delirium symptoms in critically ill patients through a systematic review.

Methods: Studies that evaluated delirium stratification scales in patients hospitalized in intensive care units were selected in a search performed in the MedLine database. Validation studies of these scales and their target patient populations were analyzed, and we identified the examiner and the signs and symptoms evaluated. In addition, the duration of the application and the sensitivity and specificity of each scale were assessed.

Results: Six scales were identified: the Delirium Detection Score, the Cognitive Test of Delirium, the Memorial Delirium Assessment Scale, the Intensive Care Delirium Screening Checklist, The Neelon and Champagne Confusion Scale and the Delirium Rating Scale-Revised-98.

Conclusion: The scales identified allow the stratification and monitoring of critically ill patients with delirium. Among the six scales, the most studied and best suited for use in the intensive care units was the Intensive Care Delirium Screening.

Objetivo: Identificar escalas capazes de estabelecer uma avaliação quantitativa dos sintomas do delirium em pacientes graves por meio de uma revisão sistemática.

Métodos: Foram selecionados estudos que avaliaram escalas de estratificação de delirium em pacientes internados em unidades de terapia intensiva a partir de busca na base de dados MedLine. Os estudos de validação dessas escalas foram analisados, e foram identificados os pacientes alvos para aplicação, o avaliador, os sinais e sintomas avaliados, a duração da aplicação, além da sensibilidade e da especificidade de cada escala.

Resultados: Seis escalas foram identificadas: o Delirium Detection Score, o Cognitive Test of Delirium, a Memorial Delirium Assessment Scale, o Intensive Care Delirium Screening Checklist, a The Neelon and Champagne Confusion Scale e a Delirium Rating Scale-Revised-98.

Conclusão: As escalas identificadas permitem estratificação e acompanhamento do paciente grave com delirium. Dentre as seis escalas, a mais estudada e que melhor se adequa ao uso em unidade de terapia intensiva foi o Intensive Care Delirium Screening Checklist.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Diagram of the results of the application of search filters, limits, and criteria for the inclusion of the delirium rating scales. ICU - intensive care unit. * Some of the studies not performed with patients in the ICU or those that involved dichotomous scales were used only as additional information for the study and were excluded from the results presented.
See this image and copyright information in PMC

References

    1. Spronk PE, Riekerk B, Hofhuis J, Rommes JH. Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Med. 2009;35(7):1276–1280. - PMC - PubMed
    1. Kishi Y, Iwasaki Y, Takezawa K, Kurosawa H, Endo S. Delirium in critical care unit patients admitted through an emergency room. Gen Hosp Psychiatry. 1995;17(5):371–379. - PubMed
    1. Lin SM, Liu CY, Wang CH, Lin HC, Huang CD, Huang PY, et al. The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med. 2004;32(11):2254–2259. - PubMed
    1. Guenther U, Popp J, Koecher L, Muders T, Wrigge H, Ely EW, et al. Validity and reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients. J Crit Care. 2010;25(1):144–151. - PubMed
    1. Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU) JAMA. 2001;286(21):2703–2710. - PubMed