Utility of the PRE-DELIRIC delirium prediction model in a Scottish ICU cohort

Abstract

The PREdiction of DELIRium for Intensive Care (PRE-DELIRIC) model reliably predicts at 24 h the development of delirium during intensive care admission. However, the model does not take account of alcohol misuse, which has a high prevalence in Scottish intensive care patients. We used the PRE-DELIRIC model to calculate the risk of delirium for patients in our ICU from May to July 2013. These patients were screened for delirium on each day of their ICU stay using the Confusion Assessment Method for ICU (CAM-ICU). Outcomes were ascertained from the national ICU database. In the 39 patients screened daily, the risk of delirium given by the PRE-DELIRIC model was positively associated with prevalence of delirium, length of ICU stay and mortality. The PRE-DELIRIC model can therefore be usefully applied to a Scottish cohort with a high prevalence of substance misuse, allowing preventive measures to be targeted.

Assessment of delirium using the PRE-DELIRIC model in an intensive care unit in Argentina

“…( 16 ) More recently, the model was applied to a Scottish cohort with a high prevalence of substance misuse, in which it predicted the development of delirium , length of ICU stay, and mortality at an early stage. ( 30 ) The model demonstrated an acceptable predictive value and an AUC similar or better than that identified in previous studies in European ICUs. Our study is the first to assess the performance of the PRE-DELIRIC model outside Europe.…”

Delirium

“…In the ICU, the PRE-DELIRIC model 68 , which is based on ten risk factors (age, APACHE-II score, admission group, coma, infection, metabolic acidosis, use of sedatives and morphine, urea concentration and urgent admission) identified within 24 hours of ICU admission, predicted delirium with an area under the receiver operating curve of 0.87 (95% CI 0.85-0.89) in the first 24 hours after admission to the ICU. The PRE-DELIRIC model showed excellent performance in clinical cohorts, including in studies from Lithuania, Scotland and Argentina [69][70][71] .…”

ICU Delirium-Prediction Models: A Systematic Review

“…Of the 20 included studies, 13 were primarily concerned with the development of new prediction models [22][23][24][25][26][27][28][29][30][31][32][33][34], six with the validation of existing models [20,[35][36][37][38][39], and one was a review article that summarized delirium prediction models published prior to January 1 st , 2013 [40] (Table 1). These studies included 26 risk prediction models, of which 18 were developed in the included studies.…”