Evaluation of the PRE-DELIRIC delirium prediction tool on a general ICU

Hanison, James; Umar, Shifa; Acharya, Krishna; Conway, Daniel H.

doi:10.1186/cc14559

Cited by 4 publications

(7 citation statements)

References 4 publications

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“…A previous study showed that PRE‐DELIRIC had a satisfactory area under receiver operating characteristic curve (AUROC) of 0.75 18 . Researchers have validated PRE‐DELIRIC in a general ICU of a university hospital in Sweden, and the results showed an AUROC of 0.77 19 . Wassenaar et al recruited 2178 patients from 11 ICUs in seven countries and showed that PRE‐DELIRIC had an AUROC of 0.74 20 .…”

Section: Introductionmentioning

confidence: 99%

Validation of PREdiction of DELIRium in ICu patients (PRE‐DELIRIC) among patients in intensive care units: A retrospective cohort study

Liang

Chau

et al. 2020

Nursing in Critical Care

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Background: An intensive care unit (ICU) delirium prediction tool, PREdiction of DELIRium in ICu patients (PRE-DELIRIC), has been developed and calibrated in a multinational project. However, there is a lack of evidence regarding the predictive ability of the PRE-DELIRIC among Chinese ICU patients.Aim: To evaluate the predictive validity (discrimination and calibration) of PRE- DELIRIC.Design: This is a retrospective cohort study.Methods: A retrospective cohort study was conducted. Consecutive participants (a) admitted to the ICU for ≥24 hours, (b) aged ≥18 years, and (c) admitted to the ICU for the first time were included. Ten predictors (age, APACHE-II, urgent and admission category, urea level, metabolic acidosis, infection, coma, sedation, and morphine use) assessed within 24 hours upon ICU admission were assessed. Delirium was assessed using the Confusion Assessment Method for ICU. Outcomes included ICU length of stay and mortality. Discrimination and calibration were determined by the areas under the receiver operating characteristic curve (AUROC), box plot, and calibration plot.Results: A total of 375 ICU patients were included, with 44.0% of patients being delirious. Delirium was significantly associated with age, PRE-DELIRIC score, ICU length of stay, and mortality. The AUROC was 0.81 (95% confidence interval, 0.77-0.86). The optimal cut-off point identified by max Youden index was 49%. The calibration plot of pooled data demonstrated a calibration slope of 0.894 and an intercept of −0.178. Conclusions:The PRE-DELIRIC has high predictive value and is suggested to be adopted in ICUs for early initiation of preventive interventions against delirium among high-risk patients.Relevance to clinical practice: Clinicians can adopt the PRE-DELIRIC among ICU patients to screen patients at high risk of developing delirium. Early initiative interventions could be implemented to reduce the negative impacts of ICU delirium.

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Section: Introductionmentioning

confidence: 99%

Validation of PREdiction of DELIRium in ICu patients (PRE‐DELIRIC) among patients in intensive care units: A retrospective cohort study

Liang

Chau

et al. 2020

Nursing in Critical Care

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“…5,14 Recently, studies on the Chinese population have reported an area under the receiver operating characteristic curve (AUROC) of 0.81, with similar findings from studies performed across 7 European countries. 14,18 In contrast, in the United Kingdom, a lower AUROC of 0.65 is just above the practical use cut-off. 14 The higher the AUROC, the better the performance of the PRE-DELIRIC score in distinguishing between patients with and patients without delirium.…”

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confidence: 87%

“…14 The higher the AUROC, the better the performance of the PRE-DELIRIC score in distinguishing between patients with and patients without delirium. 14,18 Despite the different validation studies of the PRE-DELIRIC in Europe and beyond, we need more data to verify the discrimination and calibration of the PRE-DELIRIC score in the Italian population. We thus performed a retrospective study seeking to externally validate the PRE-DELIRIC score in a cohort of Italian ICU patients and to determine predictive factors and outcomes for ICU delirium.…”

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confidence: 99%

Calibration of the PREdiction of DELIRium in ICu Patients (PRE-DELIRIC) Score in a Cohort of Critically Ill Patients

Gravante

Giannarelli

Pucci

et al. 2023

Dimens Crit Care Nurs

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Background: To predict delirium in intensive care unit (ICU) patients, the Prediction of Delirium in ICU Patients (PRE-DELIRIC) score may be used. This model may help nurses to predict delirium in high-risk ICU patients.Objectives: The aims of this study were to externally validate the PRE-DELIRIC model and to identify predictive factors and outcomes for ICU delirium.Method: All patients underwent delirium risk assessment by the PRE-DELIRIC model at admission. We used the Intensive Care Delirium Screening Check List to identify patients with delirium. The receiver operating characteristic curve measured discrimination capacity among patients with or without ICU delirium. Calibration ability was determined by slope and intercept.Results: The prevalence of ICU delirium was 55.8%. Discrimination capacity (Intensive Care Delirium Screening Check List score ≥4) expressed by the area under the receiver operating characteristic curve was 0.81 (95% confidence interval, 0.75-0.88), whereas sensitivity was 91.3% and specificity was 64.4%. The best cut-off was 27%, obtained by the max Youden index. Calibration of the model was adequate, with a slope of 1.03 and intercept of 8.14. The onset of ICU delirium was associated with an increase in ICU length of stay ( P < .0001), higher ICU mortality ( P = .008), increased duration of mechanical ventilation ( P < .0001), and more prolonged respiratory weaning ( P < .0001) compared with patients without delirium.Discussion: The PRE-DELIRIC score is a sensitive measure that may be useful in early detection of patients at high risk for developing delirium. The baseline PRE-DELIRIC score could be useful to trigger use of standardized protocols, including nonpharmacologic interventions.

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“…Its validity and predictive ability have been evaluated in several countries. 15,16 Liang et al 17 in this issue add to this body of knowledge by presenting a retrospective cohort study aimed at assessing the predictive ability of PRE-DELIRIC among Chinese ICU patients. On the basis of sample size calculations, the study included data from 375 patients admitted to a surgical ICU in Guangzhou and a general ICU in Lanzhou over a 7-month period.…”

Section: E D I T O R I a Lmentioning

confidence: 99%

“…The PREdiction of DELIRium in ICU patients (PRE‐DELIRIC) model was developed 13 and recalibrated 14 to enable early identification of delirium and commencement of preventive and therapeutic measures. Its validity and predictive ability have been evaluated in several countries 15,16 . Liang et al 17 in this issue add to this body of knowledge by presenting a retrospective cohort study aimed at assessing the predictive ability of PRE‐DELIRIC among Chinese ICU patients.…”

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confidence: 99%