New data regarding the diagnosis of delirium in the intensive care unit

Abstract

Introduction: Delirium, is an organic psychosyndrome, characterized by disturbance of consciousness and cognitive dysfunction, while it is often encountered during the stay of patients in the Intensive Care Unit. It is associated with increased mortality rates, increased length of stay on mechanical support and high healthcare costs, placing a significant burden on caregivers and healthcare systems worldwide.
Purpose: The purpose of this paper was to present the screening instruments, by highlighting the newest data regarding the treatment of the syndrome.
Materials and Methods: Global literature search was carried out, in foreign language and Greek journals, in the electronic databases: Pubmed, Google Scholar, Research Gate, and Science Direct.
Results: The global incidence of the syndrome in ICUs is 32% to 87%. Delirium is often subdiagnosed, and delayed diagnosis leads to poor outcome, prolonged patient hospitalization, increased healthcare costs, morbidity and mortality. Currently, there are five validated screening tools for Delirium in adult patients based on DSM-IV: CAM-ICU, ICDSC, DDS, Nu-DESC, Neelon & Champagne Confusion Scale. The CAM-ICU and ICDSC scales, are most used. In Greece, the CAM-ICU has been translated and validated, with the results showing that it is a reliable and valid tool for the early detection of the syndrome in Greek ICUs. However, no studies have been conducted where it is used in clinical practice.
Conclusion: Despite the availability of valid delirium screening instruments in the ICUs, systematic screening remains rare, and nurses do not apply them in clinical practice. There is a high need for more prospective studies to understand the epidemiology and risk factors for delirium and to discover further preventive interventions for ICU patients who will develop this syndrome.