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Title
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Recalibration of the delirium prediction model for ICU patients (PRE-DELIRIC) : a multinational observational study
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Author
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Abstract
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| Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients. A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 h after ICU admission. The confusion assessment method for the intensive care unit (CAM-ICU) was used to identify ICU delirium. CAM-ICU screening compliance and inter-rater reliability measurements were used to secure the quality of the data. A total of 2,852 adult ICU patients were screened of which 1,824 (64 %) were eligible for the study. Main reasons for exclusion were length of stay < 1 day (19.1 %) and sustained coma (4.1 %). CAM-ICU compliance was mean (SD) 82 +/- A 16 % and inter-rater reliability 0.87 +/- A 0.17. The median delirium incidence was 22.5 % (IQR 12.8-36.6 %). Although the incidence of all ten predictors differed significantly between centers, the area under the receiver operating characteristic (AUROC) curve of the eight participating centers remained good: 0.77 (95 % CI 0.74-0.79). The linear predictor and intercept of the prediction rule were adjusted and resulted in improved re-calibration of the PRE-DELIRIC model. In this multinational study, we recalibrated the PRE-DELIRIC model. Despite differences in the incidence of predictors between the centers in the different countries, the performance of the PRE-DELIRIC-model remained good. Following validation of the PRE-DELIRIC model, it may facilitate implementation of strategies to prevent delirium and aid improvements in delirium management of ICU patients. |
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Language
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English
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Source (journal)
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Intensive care medicine / European Society of Intensive Care Medicine; European Society of Pediatric and Neonatal Intensive Care. - Heidelberg, 1977, currens
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Publication
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Heidelberg
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2014
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ISSN
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0342-4642
[print]
1432-1238
[online]
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DOI
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10.1007/S00134-013-3202-7
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Volume/pages
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40
:3
(2014)
, p. 361-369
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ISI
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000332457400006
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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