Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

被引:46
作者
Ista, Erwin [1 ]
van Beusekom, Babette [2 ]
van Rosmalen, Joost [3 ]
Kneyber, Martin C. J. [4 ,5 ]
Lemson, Joris [6 ]
Brouwers, Arno [7 ]
Dieleman, Gwen C. [2 ]
Dierckx, Bram [2 ]
de Hoog, Matthijs [1 ]
Tibboel, Dick [1 ]
van Dijk, Monique [1 ]
机构
[1] Erasmus MC, Sophia Childrens Hosp, Dept Pediat & Pediat Surg, Intens Care Unit, Off Sb-2704,POB 2060, NL-3000 CB Rotterdam, Netherlands
[2] Erasmus MC, Sophia Childrens Hosp, Dept Child & Adolescent Psychiat & Psychol, Rotterdam, Netherlands
[3] Erasmus MC, Dept Biostat, Rotterdam, Netherlands
[4] Univ Groningen, Univ Med Ctr Groningen, Beatrix Childrens Hosp, Dept Pediat,Div Pediat Crit Care Med, Groningen, Netherlands
[5] Univ Groningen, Crit Care Anaesthesiol Peri Operat & Emergency Me, Groningen, Netherlands
[6] Radboud Univ Nijmegen, Med Ctr, Dept Intens Care, Nijmegen, Netherlands
[7] Maastricht Univ, Med Ctr, Dept Pediat, Div Pediat Intens Care, Maastricht, Netherlands
来源
CRITICAL CARE | 2018年 / 22卷
关键词
Pediatric delirium; Assessment tool; Iatrogenic withdrawal syndrome (IWS); Benzodiazepine; Sedation; PICU; WITHDRAWAL SYMPTOMS SCALE; INTENSIVE-CARE-UNIT; DIAGNOSTIC-TESTS; CRITICAL ILLNESS; RISK-FACTORS; CHILDREN; VERIFICATION; INSTRUMENTS; PREVALENCE; MANAGEMENT;
D O I
10.1186/s13054-018-2238-z
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Backgrounds: Reports of increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the pediatric delirium component (PD-scale) of the Sophia Observation Withdrawal Symptoms scale Pediatric Delirium scale (SOS-PD scale). Methods: In a multicenter prospective observational study in four Dutch pediatric ICUs (PICUs), patients aged >= 3 months and admitted for >= 48 h were assessed with the PD-scale thrice daily. Criterion validity was assessed: if the PD-scale score was >= 4, a child psychiatrist clinically assessed the presence or absence of PD according to the Diagnostic and statistical manual of mental disorders (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 coefficient (r(p)) for correlation between the PD-scale and Cornell Assessment Pediatric Delirium (CAP-D) scores. Interrater reliability was determined by comparing paired nurse-researcher PD-scale assessments and calculating the intraclass correlation coefficient (ICC). 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 overall sensitivity of 92.3% and specificity of 96.5% compared to the psychiatrist diagnosis for a cutoff score >= 4 points. The r(p) between the PD-scale and the CAP-D 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). Conclusions: The PD-scale has good reliability and validity for early screening of PD in critically ill children. It can be validly and reliably used by nurses to this aim.
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页数:11
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