Validation of PREdiction of DELIRium in ICu Patients (PRE-DELIRIC) Among Patients With Severe Pneumonia: A Prospective Cohort Study.
Chuanchuan Liu, Yunxian Wang, Yiying Luo and 2 others
PMID 41629119WHAT IT FOUND
The PRE-DELIRIC prediction tool did not identify delirium risk well in ICU severe pneumonia patients.
In 173 patients, prediction was poor. Nurses should not use it alone to target prevention; CAM-ICU checks remain important.
Key findings
01In 173 patients with severe pneumonia, the PRE-DELIRIC model had an AUROC of 0.578 (95% CI 0.493 to 0.664), which the study reported as suboptimal discrimination.
02At the optimal cut-off of 0.1663, sensitivity was 0.793 and specificity was 0.374.
03Delirium occurred in 82 of 173 patients, and patients with delirium had significantly longer ICU stays and higher mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
It was a single-centre study with 173 patients, so the result may not apply to other ICUs or populations. Delirium was checked only twice daily, so episodes that came and went may have been missed. 40 patients were excluded because delirium could not be assessed precisely, which may understate how common delirium is in severe pneumonia. Some PRE-DELIRIC variables had no variation in this cohort, including admission category, infection, morphine use, and urgent admission, so they could not help predict delirium here. Five APACHE-II values were missing and were imputed.
Declared interests
The authors declared no conflicts of interest. Funding came from the Chongqing Municipal Education Commission, the First Affiliated Hospital of Chongqing Medical University, and the School of Nursing, Chongqing Medical University.
The easy way to misread this
Do not conclude that severe pneumonia patients cannot be identified as at risk for delirium. This paper only tested one existing model, PRE-DELIRIC, and found it performed poorly; delirium still occurred in 82 of 173 patients and was associated with longer ICU stays and higher mortality.