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Critical Care

, 17:P398 | Cite as

International validation of the delirium prediction model for ICU patients (PREDELIRIC): a multicenter observational study

  • M van den Boogaard
  • L Schoonhoven
  • E Maseda
  • C Plowright
  • C Jones
  • A Luetz
  • PV Sackey
  • P Jorens
  • LM Aitken
  • F van Haren
  • JG van der Hoeven
  • P Pickkers
Poster presentation
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Keywords

Morphine Metabolic Acidosis Multicenter Cohort Multicenter Cohort Study Multicenter Observational Study 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

Delirium is a serious and frequent disorder in ICU patients. The aim of this study was to internationally validate the existing Prediction of Delirium ICU (PREDELIRIC) model to predict delirium in ICU patients.

Methods

A prospective multicenter cohort study was performed in eight ICUs in six countries (Table 1). The 10 predictors (age, APACHE II score, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 hours after ICU admission. CAM-ICU was used to identify ICU delirium.
Table 1

PREDELIRIC AUROC of different centers

 

Delirium (%)

AUROC

95% CI

Belgium (%)

86 (15.2)

0.79

0.74 to 0.84

Germany (%)

60 (26.9)

0.85

0.80 to 0.91

Spain (%)

23 (18.0)

0.88

0.81 to 0.94

Sweden (%)

30 (39.0)

0.71

0.60 to 0.83

Australia Brisbane (%)

42 (12.8)

0.81

0.75 to 0.88

Australia Canberra (%)

23 (11.8)

0.80

0.72 to 0.89

UK_Prescot (%)

73 (30.8)

0.65

0.57 to 0.73

UK_Kent (%)

26 (36.6)

0.76

0.65 to 0.88

PREDELIRIC overall

363 (19.9)

0.77

0.74 to 0.79

Results

A total of 2,852 adult ICU patients were screened and 1,824 (64%) were included. Main exclusion reasons were length of stay <1 day (19.1%) and sustained coma (4.1%). Mean ± CAM-ICU compliance was 82 ± 16% and inter-rater reliability 0.87 ± 0.17. Overall delirium incidence was 19.9% (range 27.2%). Despite significant differences between centres on all 10 predictors, the overall area under the receiver operating characteristic curve (AUROC) of the eight centers was 0.77 (95% CI: 0.74 to 0.79).

Conclusion

The overall predictive value of the PREDELIRIC model was good, indicating that the prediction model can now be used internationally.

Copyright information

© van den Boogaard et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • M van den Boogaard
    • 1
  • L Schoonhoven
    • 2
  • E Maseda
    • 3
  • C Plowright
    • 4
  • C Jones
    • 5
  • A Luetz
    • 6
  • PV Sackey
    • 7
  • P Jorens
    • 8
  • LM Aitken
    • 9
  • F van Haren
    • 10
  • JG van der Hoeven
    • 1
  • P Pickkers
    • 1
  1. 1.Radboud University Nijmegen Medical CentreNijmegenthe Netherlands
  2. 2.Radboud University Nijmegen Medical CentreScientific Institute for Quality of HealthcareNijmegenthe Netherlands
  3. 3.Hospital Universitario La PazMadridSpain
  4. 4.Medway Maritime HospitalKentUK
  5. 5.Whiston HospitalPrescotUK
  6. 6.Charité - Universitaetsmedizin BerlinGermany
  7. 7.Karolinska University HospitalStockholmSweden
  8. 8.University of AntwerpenBelgium
  9. 9.Princess Alexandra HospitalWoolloongabbaAustralia
  10. 10.Canberra HospitalCanberraAustralia

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