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Intensive Care Med (2016) 42:122123DOI 10.1007/s00134-015-3964-1 LETTER
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Web End = Anne Julie Frenette Emmanuel R. Bebawi Louis C. Deslauriers Andre-Anne L. Tessier Marc M. Perreault Marie-Soleil Delisle Jean-Claude Bertrand Monique Desjardins Philippe RicoKosar KhwajaLisa D. BurryFrancis BernardDavid R. Williamson
cognitive impairment, and mortality [13]. Guidelines recommend routine screening for delirium in ICU patients using a validated tool [4]. Traumatic brain injury (TBI) can induce focal or diffuse brain damage, which may predispose patients to neuropsychiatric complications including delirium as well as complexify its evaluation [5]. The aim of our study was to evaluate the validity and reliability of both the Confusion Assessment MethodIntensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) for delirium assessment in patients with mild [Glasgow Coma Scale (GCS 1315)] or moderate (GCS 912) TBI.
A prospective observational study was conducted in two academic trauma centers. Patients of 18 years of age or older and admitted to ICU for more than 48 h were screened for inclusion if they had mild or moderate TBI. Exclusion criteria included severe TBI (GCS 38), Richmond Agitation Sedation Scale (RASS) score of -4 or -5 throughout the ICU stay, pre-existing cognitive impairment, inability to uently communicate in English or French, and signicant blindness or deafness that precluded adequate assessment. Written informed consent was obtained from all patients or their legal representative. Patients underwent evaluation with the CAM-ICU, ICDSC, and DSM-IV-TR criteria for delirium on days 3, 5, and 7 of ICU stay. Assessments were performed independently when RASS was superior to -3 and results were blinded. Trained pharmacy residents and ICU pharmacists performed delirium assessments with the CAM-ICU and
ICDSC while physicians (psychiatrists and intensivists) performed DSM-IV-TR. Criterion validity analyses were performed for each evaluation day separately (days 3, 5 and 7) and all together. Estimates of 95 % condence intervals (CIs) for binary repeated data using generalized estimating equation (GEE) in conjunction with...