Azuma Kazunari, Mishima Shiro, Shimoyama Keiichiro, Ishii Yuri, Ueda Yasuhiro, Sakurai Masako, Morinaga Kentaro, Fujikawa Tsubasa, Oda Jun
Department of Emergency and Critical Care Medicine Tokyo Medical University Shinjuku-ku Tokyo Japan.
Acute Med Surg. 2018 Dec 3;6(1):54-59. doi: 10.1002/ams2.378. eCollection 2019 Jan.
Subsyndromal delirium is associated with prolonged intensive care unit stays, and prolonged mechanical ventilation requirements. The Prediction of Delirium for Intensive Care (PRE-DELIRIC) model can predict delirium. This study was designed to verify if it can also predict development of subsyndromal delirium.
We undertook a single-center, retrospective observation study in Japan. We diagnosed subsyndromal delirium based on the Intensive Care Delirium Screening Checklist. We calculated the sensitivity and specificity of the PRE-DELIRIC model and obtained a diagnostic cut-off value.
We evaluated data from 70 patients admitted to the mixed medical intensive care unit of the Tokyo Medical University Hospital (Tokyo, Japan) between May 2015 and February 2017. The prevalence of subsyndromal delirium by Intensive Care Delirium Screening Checklist was 31.4%. The area under the receiver operating characteristic curve was 0.83 of the PRE-DELIRIC model for subsyndromal delirium. The calculated cut-off value was 36 points with a sensitivity of 94.3% and specificity of 57.1%. Subsyndromal delirium was associated with a higher incidence of delirium (odds ratio, 8.81; < 0.01).
The PRE-DELIRIC model could be a tool for predicting subsyndromal delirium using a cut-off value of 36 points.
亚综合征性谵妄与重症监护病房住院时间延长及机械通气需求延长有关。重症监护谵妄预测（PRE-DELIRIC）模型可预测谵妄。本研究旨在验证该模型是否也能预测亚综合征性谵妄的发生。
我们在日本进行了一项单中心回顾性观察研究。我们根据重症监护谵妄筛查清单诊断亚综合征性谵妄。我们计算了PRE-DELIRIC模型的敏感性和特异性，并获得了诊断临界值。
我们评估了2015年5月至2017年2月期间入住东京医科大学医院（日本东京）混合医疗重症监护病房的70例患者的数据。根据重症监护谵妄筛查清单，亚综合征性谵妄的患病率为31.4%。PRE-DELIRIC模型预测亚综合征性谵妄的受试者工作特征曲线下面积为0.83。计算出的临界值为36分，敏感性为94.3%，特异性为57.1%。亚综合征性谵妄与谵妄的较高发生率相关（优势比，8.81；<0.01）。
PRE-DELIRIC模型可以作为一种使用36分临界值预测亚综合征性谵妄的工具。
