%0 Journal Article
%T Delirium assessment in the intensive care unit: patient population matters
%A Margaret A Pisani
%J Critical Care
%D 2008
%I BioMed Central
%R 10.1186/cc6847
%X The Diagnostic and Statistical Manual of Mental Disorders IV diagnostic criteria for delirium are disturbances of consciousness and change in cognition that develops over a short period of time and fluctuates during the course of the day. There also must be evidence from the history, physical examination, or laboratory findings that this disturbance is caused by the direct physiological consequences of a general medical condition.The prevalence of delirium in critical illness and the importance of its impact on intensive care unit (ICU) outcomes have recently gained recognition in the literature [1]. Delirium may persist after an ICU stay and may have long-term effects on cognitive and functional abilities as well as impacting on the patient's quality of life. Current critical care practice guidelines recommend routine delirium screening [2].While there has been ongoing research into delirium in noncritically ill patients for many years, only recently has attention been given to delirium in the ICU [3]. The instruments used to assess delirium in noncritically ill patients are often not suited to the unique needs of a critical care population. The characteristics of patients in a critical care environment have hindered development of standardized delirium assessments. Some issues that ICU delirium screening instruments need to address are the inability of intubated patients to participate in a verbal assessment, the severity of illness, and limitations on staff time that may preclude a lengthy cognitive assessment.There are six delirium assessment instruments in the literature that have been evaluated in an ICU setting. These instruments are presented in Table 1 and are based in part on the Diagnostic and Statistical Manual of Mental Disorders criteria for diagnosing delirium. Each of these scales has been validated, but the patient populations assessed with these instruments have varied from study to study and the extent of the validation efforts have also varied. T
%U http://ccforum.com/content/12/2/131