Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
Res Nurs Health. 2022 Feb;45(1):23-33. doi: 10.1002/nur.22194. Epub 2021 Nov 3.
The nursing delirium screening scale (Nu-DESC) was developed for the rapid assessment of delirium, but little is known regarding the performance of the Nu-DESC in assessing postoperative delirium. The purpose of this systematic review and meta-analysis was to review and summarize the evidence of the diagnostic accuracy of the Nu-DESC in assessing postoperative delirium. The EMBASE, MEDLINE, Cochrane Library, CINAHL, and a Chinese e-Journal database were searched from the period of the inception of the Nu-DESC to June 18, 2020. Participants were adult (age ≥ 18 years) postoperative patients who received any type of surgery and any method of anesthesia. The quality assessment of diagnostic accuracy studies-2 was employed to assess the risk of bias among the selected studies, and meta-regression analyses were used to detect sources of between-study heterogeneity. Eleven studies involving 2062 postoperative patients in surgical settings were included. The Nu-DESC revealed a pooled sensitivity of 0.73 (95% confidence interval, 0.44-0.90) and a specificity of 0.93 (0.87-0.96). The area under the summary receiver operating characteristics curve was 0.94 (0.91-0.96), which also confirmed the accuracy of the Nu-DESC. Covariates, including the region of study and the standard reference used, were identified as possible sources of heterogeneity in the meta-regression. The findings of this review can update existing clinical guidelines for postoperative delirium. On the basis of its satisfactory diagnostic performance, we suggest that the Nu-DESC could be considered for nurses and allied health professionals for assessing postoperative delirium. However, because of the heterogeneity, the result of this meta-analysis should be considered with caution.
护理谵妄筛查量表（Nu-DESC）是为快速评估谵妄而开发的，但关于 Nu-DESC 评估术后谵妄的性能知之甚少。本系统评价和荟萃分析的目的是回顾和总结 Nu-DESC 评估术后谵妄的诊断准确性证据。从 Nu-DESC 成立到 2020 年 6 月 18 日，我们在 EMBASE、MEDLINE、Cochrane 图书馆、CINAHL 和一个中国电子期刊数据库中进行了搜索。参与者为接受任何类型手术和任何麻醉方法的成年（年龄≥18 岁）术后患者。采用诊断准确性研究质量评估-2 来评估所选研究的偏倚风险，并进行荟萃回归分析以检测研究间异质性的来源。11 项研究共纳入 2062 例手术患者。Nu-DESC 显示出 0.73 的汇总敏感性（95%置信区间，0.44-0.90）和 0.93 的特异性（0.87-0.96）。汇总受试者工作特征曲线下面积为 0.94（0.91-0.96），这也证实了 Nu-DESC 的准确性。协变量，包括研究区域和使用的标准参考，被确定为荟萃回归中异质性的可能来源。本综述的结果可以更新现有的术后谵妄临床指南。基于其令人满意的诊断性能，我们建议护士和相关卫生专业人员在评估术后谵妄时可以考虑使用 Nu-DESC。然而，由于存在异质性，因此应谨慎考虑本荟萃分析的结果。
