Comparison of two delirium assessment tools in neurosurgery patients without mechanical ventilation
10.3760/cma.j.issn.1674-2907.2019.04.004
- VernacularTitle:两种谵妄评估表在神经外科非机械通气患者中的应用比较
- Author:
Yufei LIU
1
;
Zhenxian SHI
;
Caiyun ZHANG
;
Li SHEN
;
Shulin WANG
Author Information
1. 山西中医药大学研究生院,太原 030000
- Keywords:
Delirium;
Evaluation;
Neurosurgery;
Intensive Care Delirium Screening Checklist;
Neelon and Champagne Confusion Scale
- From:
Chinese Journal of Modern Nursing
2019;25(4):404-407
- CountryChina
- Language:Chinese
-
Abstract:
Objective? To compare the reliability and validity of Intensive Care Delirium Screening Checklist (ICDSC) and Neelon and Champagne Confusion Scale (NEECHAM) when evaluating non-mechanical ventilation patients in Neurosurgery Department. Methods? A total of 100 non-mechanical ventilation patients in the Neurosurgery Department of a ClassⅢ Grade A hospital in Shanxi Province from August to December 2018 were selected. The non-operative patients were assessed on the third day after admission, and the operative patients were assessed on the third day after operation. Qualified nurses assessed the patients at 00:00—1:00, 8:00—9:00 and 16:00—17:00 with ICDSC and NEECHAM. Psychiatrists assess the patients at 16:30—17:30 on the same day by Richmond Agitation and Sedation Scale (RASS) and Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Using the results of DSM-IV as the gold standard, the curve of ROC was drawn, and the sensitivity and specificity of the two scales were compared. Results? Area under ROC Curve (ROCAUC) of ICDSC was 0.891 (95%CI: 0.826-0.956,P＜0.01). The ROCAUC of NEECHAM was 0.987 (95% CI: 0.970-0.999, P＜ 0.01). When the optimal threshold of ICDSC was 4.25, the sensitivity and specificity were 87.8% and 76.2% respectively. When the optimal threshold of NEECHAM was 23.5, the sensitivity and specificity were 98.0% and 92.9% respectively. Conclusions? The misdiagnosis rate of NEECHAM is lower than ICDSC, and the diagnostic efficacy, authenticity, reliability and diagnostic value of NEECHAM are higher than ICDSC. NEECHAM is more suitable for nurses to evaluate delirium in neurosurgery patients without mechanical ventilation.
