Lin Chia-Jou, Fick Donna Marie, Traynor Victoria, Chen Yi-Chen, Hsiang Hui-Fen, Chiu Hsiao-Yean
School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, Pennsylvania, USA.
J Clin Nurs. 2025 Jan;34(1):287-298. doi: 10.1111/jocn.17467. Epub 2024 Sep 27.
To synthesise the evidence on and to compare the diagnostic accuracy of the Nu-DESC and CAM in detecting postoperative delirium among hospitalised patients.
Systematic review and diagnostic meta-analysis.
The PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses A&I, and PsycINFO databases were systematically searched from their inception to February 10, 2023.
In total, 10 (n = 1950) and seven (n = 830) reports were included for the Nu-DESC and CAM, respectively. For Nu-DESC and CAM, the pooled sensitivities were 0.69 and 0.65, respectively, while the summary specificities were 0.99 for Nu-DESC and 0.92 for CAM. The pooled specificity differed significantly between the two tools (p < 0.001), despite comparable pooled sensitivities. The duration of stay in the intensive care unit significantly moderated the summary specificity of Nu-DESC (B = -0.0003, p = 0.009). Regarding CAM, the percentage of female participants showed a positive correlation with its pooled sensitivity (B = 0.005, p = 0.02). Furthermore, studies where clinical specialists served as assessors demonstrated a higher summary sensitivity than those assessed by nurses (0.87 vs. 0.25, p = 0.01).
The sensitivities of the Nu-DESC and CAM for detecting postoperative delirium did not achieve optimal levels. Therefore, developing more accurate tools to detect postoperative delirium by integrating features from related risk factors or incorporating technology-based algorithms to enhance the screening capability is warranted.
The study has adhered to PRISMA-DTA guideline.
No patient or public contribution.
The study protocol has been registered on PROSPERO (CRD42023398961).
综合有关Nu-DESC和CAM在检测住院患者术后谵妄方面的证据，并比较二者的诊断准确性。
系统评价和诊断性荟萃分析。
对PubMed、Embase、护理及相关健康文献累积索引、ProQuest学位论文与学术期刊数据库以及PsycINFO数据库从建库至2023年2月10日进行系统检索。
分别纳入了10篇（n = 1950）关于Nu-DESC和7篇（n = 830）关于CAM的报告。对于Nu-DESC和CAM，合并敏感度分别为0.69和0.65，而Nu-DESC的汇总特异度为0.99，CAM的汇总特异度为0.92。尽管合并敏感度相当，但两种工具的合并特异度差异显著（p < 0.001）。重症监护病房的住院时间显著调节了Nu-DESC的汇总特异度（B = -0.0003，p = 0.009）。关于CAM，女性参与者的比例与其合并敏感度呈正相关（B = 0.005，p = 0.02）。此外，由临床专家作为评估者的研究显示汇总敏感度高于由护士评估的研究（0.87对0.25，p = 0.01）。
Nu-DESC和CAM检测术后谵妄的敏感度未达到最佳水平。因此，有必要通过整合相关危险因素的特征或纳入基于技术的算法来开发更准确的工具，以提高检测术后谵妄的筛查能力。
本研究遵循PRISMA-DTA指南。
无患者或公众参与。
本研究方案已在PROSPERO上注册（CRD42023398961）。
