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Abstract O-01: DELIRIUM IN THE PICU

Ista, E.1; van Beusekom, B.2; van Rosmalen, J.3; Kneyber, M.4; Lemson, J.5; Brouwers, A.6; Dieleman, G.2; Dierckx, B.2; de Hoog, M.1; Tibboel, D.1; van Dijk, M.1

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 4
doi: 10.1097/PCC.0000000000001574
Oral Abstracts
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1Erasmus University Medical Center - Sophia Children’s Hospital, Intensive Care Unit, Rotterdam, The Netherlands

2Erasmus University Medical Center - Sophia Children’s Hospital, Department of Child and Adolescent Psychiatry and Psychology, Rotterdam, The Netherlands

3Erasmus University Medical Center, Department of Biostatistics, Rotterdam, The Netherlands

4Beatrix Children’s Hospital- University Medical Center Groningen, Department of Pediatrics- Division of Pediatric Critical Care Medicine, Groningen, The Netherlands

5Radboud University Medical Center, Intensive Care, Nijmegen, The Netherlands

6Maastricht University Medical Centre+, Pediatrics- Division Pediatric Intensive Care, Maastricht, The Netherlands

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Aims & Objectives:

Reports on increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the peadiatric delirium component (PD-scale) of the SOS-PD scale.

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Methods

In a multicenter prospective observational study in four Dutch PICUs, patients aged ≥3 months and admitted for ≥48 hours were assessed with the PD-scale thrice daily. Criterion validity was assessed: if the PD-scale score was 4 or higher, a child psychiatrist clinically assessed the presence or absence of PD diagnosis according to the DSM-IV. In addition, the child psychiatrist assessed a randomly selected group to establish the false-negative rate. The construct validity was assessed by calculating the Pearson correlation (rp) coefficient between the PD-scale and the CAP-D scores. Interrater reliability was determined by comparing paired nurse and researcher PD-scale assessments and calculating the intraclass correlation coefficient (ICC).

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Results

Four hundred eighty-five patients with a median age of 27.0 months (IQR 8–102) were included, of whom 48 patients were diagnosed with delirium by the child psychiatrist. The PD-scale had an overall sensitivity of 92.2% and a specificity of 96.9% compared to the psychiatrist diagnosis for a cut-off score of 4 points. The correlation (rp) between the PD-scale and the CAP-D scores was 0.89 (CI 95% 0.82–0.93; p<0.001). The ICC of 75 paired nurse-researcher observations was 0.99 (95% CI 0.98–0.99).

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Conclusions

The PD-scale shows a good validity for early screening of PD. It can be validly and reliably used by nurses to assess presence of delirium in critically ill children.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies