{"id":2376,"date":"2014-01-31T14:30:44","date_gmt":"2014-01-31T14:30:44","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/ssdcc\/"},"modified":"2025-05-13T20:27:29","modified_gmt":"2025-05-13T20:27:29","slug":"ssdcc","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/ssdcc\/","title":{"rendered":"Scoring Systems for the Diagnosis of Delirium in Critically Ill Patients"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Two scales are in common use, the Confusion Assessment Method for the ICU (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC).<br \/>\n<!--more--><br \/>\n<strong style=\"line-height: 1.3em;\">Scoring Systems for the Diagnosis of Delirium\u00a0<span style=\"line-height: 1.3em;\">in Critically Ill Patients<\/span><\/strong><br \/>\n<strong><br \/>\nConfusion Assessment Method for the ICU (CAM-ICU)*<\/strong><br \/>\nScoring is positive or negative according to the presence\u00a0<span style=\"line-height: 1.3em;\">or absence of criteria listed<\/span><br \/>\nPatient must be sufficiently awake (RASS score,\u00a0<span style=\"line-height: 1.3em;\">-3 or more) <\/span><span style=\"line-height: 1.3em;\">for assessment according to the following criteria:<\/span><br \/>\nAn acute change from mental status at baseline or\u00a0<span style=\"line-height: 1.3em;\">fluctuating mental status during the past 24 hr <\/span><span style=\"line-height: 1.3em;\">(must be true to be positive)<\/span><br \/>\nMore than 2 errors on a 10 \u00adpoint test of attention to\u00a0<span style=\"line-height: 1.3em;\">voice or pictures (must be true to be positive)<\/span><br \/>\nIf the RASS is not 0 and the above two criteria are\u00a0<span style=\"line-height: 1.3em;\">positive, the patient is delirious<\/span><br \/>\nIf the RASS is 0 and the above two criteria are posi\u00ad<span style=\"line-height: 1.3em;\">tive, test for disorganized thinking using 4 yes\/no <\/span><span style=\"line-height: 1.3em;\">questions and a 2\u00ad step command; &gt;1 error means <\/span><span style=\"line-height: 1.3em;\">the patient is delirious; &lt;\/=1 error excludes delirium<\/span><br \/>\n<strong><br \/>\nIntensive Care Delirium Screening Checklist (ICDSC)<\/strong><br \/>\nA score of &gt;\/=4 is positive for delirium (with scores of 1 to\u00a0<span style=\"line-height: 1.3em;\">3 termed \u201csubsyndromal delirium\u201d)<\/span><br \/>\nPatient must show at least a response to mild or moderate\u00a0<span style=\"line-height: 1.3em;\">stimulation. Then score 1 point for each of the <\/span><span style=\"line-height: 1.3em;\">following features, as assessed in the manner <\/span><span style=\"line-height: 1.3em;\">thought appropriate by the clinician:<\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Anything other than \u201cnormal wakefulness\u201d<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Inattention<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Disorientation<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Hallucination<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Psychomotor agitation<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Inappropriate speech or mood<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Disturbance in sleep or wake cycle<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Fluctuation in symptoms<\/span><\/li>\n<\/ul>\n<p>* RASS denotes Richmond Agitation\u2013Sedation Scale.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li><span style=\"line-height: 1.3em;\">Reade MC, Finfer S. Sedation and delirium in the intensive care unit. N Engl J Med. 2014 Jan 30;370(5):444-54. <\/span><a style=\"line-height: 1.3em;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24476433\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li><span style=\"line-height: 1.3em;\">Brummel NE, Girard TD. Preventing delirium in the intensive care unit. Crit Care Clin. 2013 Jan;29(1):51-65. <\/span><a style=\"line-height: 1.3em;\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23182527\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Bergeron N, Dubois MJ, Dumont M, Dial S, Skrobik Y. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med. 2001 May;27(5):859-64.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11430542\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001 Dec 5;286(21):2703-10.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11730446\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<div><\/div>\n<div>Created Feb 25, 2014.<\/div>\n<p><\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[148],"tags":[629,995,994,993,536,535,123,13,992,991,990,973,450,794,494,798],"class_list":["post-2376","post","type-post","status-publish","format-standard","hentry","category-critical-care","tag-care","tag-critical","tag-critically","tag-criticamente","tag-delirio","tag-delirium","tag-diagnosis","tag-diagnostico","tag-enfermos","tag-ill","tag-pacientes","tag-patients","tag-score","tag-scoring","tag-sistema","tag-systems"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2376","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2376"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2376\/revisions"}],"predecessor-version":[{"id":9291,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2376\/revisions\/9291"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2376"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2376"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2376"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}