Department of Anesthesiology and Surgical Intensive Care Medicine, Campus Charité Mitte, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
World J Surg. 2010 Mar;34(3):487-94. doi: 10.1007/s00268-009-0376-9.
Postoperative delirium is associated with adverse outcome. The aim of this study was to find a valid and easy-to-use tool to screen for postoperative delirium on the surgical ward.
Data were collected from 88 patients who underwent elective surgery. Delirium screening was performed daily until the sixth postoperative day using the Confusion Assessment Method (CAM), the Nursing Delirium Screening Scale (Nu-DESC), and the Delirium Detection Score (DDS), and the DSM-IV criteria as the gold standard.
Seventeen of 88 patients (19%) developed delirium on at least one of the postoperative days according to the gold standard. The DDS scored positive for 40 (45%) patients, the CAM for 15 (17%), and the Nu-DESC for 28 (32%) patients. Sensitivity and specificity were 0.71 and 0.87 for the DDS, 0.75 and 1.00 for the CAM, and 0.98 and 0.92 for the Nu-DESC. The interrater reliability was 0.83 for the Nu-DESC, 0.77 for the DDS, and 1.00 for the CAM.
All scores showed high specificity but differed in their sensitivity. The Nu-DESC proved to be the most sensitive test for screening for a postoperative delirium on the surgical ward followed by the CAM and DDS when compared to the gold standard.
术后谵妄与不良结局相关。本研究旨在找到一种有效的、易于使用的工具，以便在外科病房筛查术后谵妄。
从 88 例行择期手术的患者中收集数据。使用谵妄评估方法（CAM）、护理谵妄筛查量表（Nu-DESC）和谵妄检测评分（DDS），以及DSM-IV 标准作为金标准，每天对患者进行谵妄筛查，直至术后第 6 天。
根据金标准，88 例患者中有 17 例（19%）至少在 1 个术后日发生了谵妄。40 例（45%）患者的 DDS 评分阳性，15 例（17%）患者的 CAM 评分阳性，28 例（32%）患者的 Nu-DESC 评分阳性。DDS 的灵敏度和特异性分别为 0.71 和 0.87，CAM 的灵敏度和特异性分别为 0.75 和 1.00，Nu-DESC 的灵敏度和特异性分别为 0.98 和 0.92。Nu-DESC 的组内信度为 0.83，DDS 的组内信度为 0.77，CAM 的组内信度为 1.00。
所有评分的特异性均较高，但敏感性不同。与金标准相比，Nu-DESC 是外科病房筛查术后谵妄最敏感的测试，其次是 CAM 和 DDS。
