Table 5.
IWS and delirium: summary of recommended assessment tools for critically ill children
| Withdrawal Assessment Tool version-1 (WAT-1) [57, 58] | Sophia Observation withdrawal Symptoms-scale (SOS) [59, 60] | Paediatric Confusion Assessment Method-Intensive Care Unit (pCAM-ICU) [66] | Cornell Assessment Paediatric-Delirium (CAP-D) [65, 71] | Sophia Observation withdrawal Symptoms-Paediatric Delirium scale (SOS-PD) [72, 73] | |
|---|---|---|---|---|---|
| Age range | Children 0–16 years | Children 0–16 years | 5–16 years | 0–21 years | 0–16 years |
| Variables assessed | Loose/watery stools Vomiting/retching/gagging Temperature > 37.8 °C State* Tremor Sweating Uncoordinated/repetitive movement Yawning of sneezing Startle to touch Muscle tone Time to gain calm state (SBS ≤ 0) |
Tachycardia Tachypnoea Fever (≥38.5 °C) Sweating Agitation Anxiety Tremors Increased muscle tension Inconsolable crying Grimacing Sleeplessness Motor disturbance Hallucinations Vomiting Diarrhoea |
Four features: 1. Acute change or fluctuation course of mental status 2. Inattention 3. Altered level of consciousness 4. Disorganized thinking |
Eye contact with caregiver Purposeful actions Awareness of surrounding Communicate needs Restless Inconsolable Underactive Response to interaction |
Agitation (restless), anxiety, eye contact, grimacing impaired attention Speech Tremors Muscle tone Purposeful actions Sleeplessness Hallucinations Disorientation Sweating Acute change/fluctuation Parents |
| Score range (cut off point) |
0–12 points ≥3 |
0–15 points ≥4 |
Features 1, 2 and 3 or 4a | 0–40 (9) |
0–15 (4) |
| Reliability data | + | + | + | + | ± |
| Forms of validity established | Content, construct, responsiveness | Face, construct | Criterion | Criterion | Face (criterion pilot) |
| Clinical utility | Feasibility and utility established at bedside | Feasibility and utility established at bedside | Feasibility | Utility established at bedside | Feasibility |
| Grade | A | A | B | A | C |
See supplementary material for detailed data regarding psychometric properties
aDelirium diagnosis using the Pediatric Confusion Assessment Method for the Intensive Care Unit requires positive features 1 and 2 with either positive feature 3 or 4