Table 2.
Delirium Prevalance and Delirium Tool Psychometrics for this Systematic Review of Delirium Monitoring in the Neurocritically Ill
| Author (Reference) | Delirium Prevalencea | Delirium Tool (ReferenceStandard) | Sens | Spec | PPV | NPV | Kappa |
|---|---|---|---|---|---|---|---|
| Frenette (43) | Not stated for Tool (45.9% by Ref Std) | CAM-ICU (DSM-IV) ICDSC (DSM-IV) |
62% (95%CI: 44–76) 64% (95%CI: 49–77) |
74% (95%CI: 59–85) 79% (95%CI: 63–89) |
63% (95%CI: 45–78) 74% (95%CI: 55–87) |
70% (95%CI: 55–82) 69% (95%CI: 54–81) |
0.64 0.68 |
| Kostalova (44) | 43% (Not stated for Ref Std) | CAM-ICU (DSM-IV) | - | - | - | - | |
| Lees (45) | 27% (11% by Ref Std) | 4AT (CAM) | 100% (95%CI: 74–100) | 82% (95%CI: 72–89) | 43% (No CI) | 100% (No CI) | |
| Mitasova (46) | 24% (28% by Ref Std) | CAM-ICU, Czech (DSM-IV) | 76% (95%CI: 55–91) | 98% (95%CI: 93–100) | 91% (95%CI: 70–99) | 94% (95%CI: 88–98) | 0.94 (95% CI: 0.83–1.0) |
| Naidech (47) | 27% | CAM-ICU (N/A) | - | - | - | - | |
| Oldenbeuving (48) | 11.8%; 95% CI: 9.0–15.1 | CAM (N/A) | - | - | - | - | |
| Rosenthal (49) | 30% | CAM-ICU (N/A) | - | - | - | - |
4AT, 4-A Test; CAM-ICU, Confusion Assessment Method-ICU; CAM, Confusion Assessment Method; CI, Confidence Interval; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; ICDSC, Intensive Care Delirium Screening Checklist; Kappa, unit of interrater reliability; NPV, Negative Predictive Value; PPV, Positive Predictive Value; Ref Std, Reference Standard Delirium Assessment; Sens, Sensitivity; Spec, Specificity
The term prevalence was conservatively chosen as a more inclusive epidemiologic term encompassing old and new cases of delirium; although some articles reported incidence without clarifying how new cases were distinguished