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The diagnostic threshold of Cornell assessment of pediatric delirium in detection of postoperative delirium in pediatric surgical patients.
Hong, Hong; Guo, Chao; Liu, Zhi-Hua; Wang, Bo-Jie; Zhou, Shu-Zhe; Mu, Dong-Liang; Wang, Dong-Xin.
Afiliação
  • Hong H; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China.
  • Guo C; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China.
  • Liu ZH; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China.
  • Wang BJ; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China. ivyxbd@hotmail.com.
  • Zhou SZ; Department of Psychiatry, Peking University Sixth Hospital (Institute of Mental Health), No. 51, Hua-Yuan Road, Hai Dian District, 100191, Beijing, China. zhoushuzhe@bjmu.edu.cn.
  • Mu DL; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China.
  • Wang DX; Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, No. 8, Xi-Shi-Ku Street, Xi Cheng District, 100034, Beijing, China.
BMC Pediatr ; 21(1): 87, 2021 02 17.
Article em En | MEDLINE | ID: mdl-33596858
BACKGROUND: Cornell assessment of pediatric delirium (CAPD) showed advantage in diagnosis of pediatric delirium in Chinese critically ill patients. But its performance in surgical patients is still unclear. The present study was designed to validate the diagnostic performance of CAPD in surgical pediatric patients. METHODS: This is a prospective validation study. Pediatric patients who underwent selective surgery and general anesthesia were enrolled. Primary outcome was the incidence of delirium within postoperative three days. CAPD Chinese version was used to evaluate if the patient had delirium one time per day. At the meantime, a psychiatrist employed Diagnostic and Statistical Manual of Mental Disorders fifth edition to diagnose delirium, which was the "gold standard", and the result was considered as reference standard. Sensitivity, specificity and area under receiver operating characteristic (ROC) curve were calculated to investigate the performance of CAPD. RESULTS: A total of 170 patients were enrolled. Median age was 4 years old. As diagnosed by psychiatrist, 23 (13.5 %) patients experienced at least one episode of delirium during the follow-up period. When diagnostic threshold was set at 9, CAPD showed the optimal sensitivity (87.0 %, 95 %CI 65.3 %-96.6 %) and specificity (98.0 %, 95 %CI 93.7 %-99.5 %) in comparison with other diagnostic thresholds. ROC analysis showed that CAPD was a good delirium assessment instrument with area under curve of 0.911 (95 % CI 0.812 to 1.000, P < 0.001). Agreement between CAPD and reference standard was 0.849 (Kappa coefficient, P < 0.001). CONCLUSIONS: This study found that Cornell assessment of pediatric delirium could be used as an effective instrument in diagnosis of delirium in pediatric surgical patients. TRIAL REGISTRATION: www.chictr.org.cn Identifier: ChiCTR-DDD-17,012,231, August 3, 2017.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Delírio Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Delírio Tipo de estudo: Diagnostic_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans Idioma: En Revista: BMC Pediatr Assunto da revista: PEDIATRIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China