Diagnostic Accuracy of the Pediatric CAM-ICU, Pre-school CAM-ICU, Pediatric Anesthesia Emergence Delirium and Cornell Assessment of Pediatric Delirium for Detecting Delirium in the Pediatric Intensive Care Unit: A Systematic Review and Meta-Analysis

Intensive & Critical Care Nursing

Rohmah, I., Chen, Y. C., et al. (2024).

Intensive & Critical Care Nursing, 82, 103606.

<div>This systematic review with meta-analysis investigates the diagnostic accuracy of assessment tools for detecting delirium in children, from birth to 21 years old, in the pediatric intensive care unit (PICU). Of note, although speech-language pathologists (SLPs) do not diagnose delirium, SLPs may administer delirium screening tools as part of a multidisciplinary effort to prevent and manage delirium.</div>

National Science and Technology Council (Taiwan)

From database inception to March 1, 2023

<div>Observational studies reporting sensitivity and specificity</div>

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<div>For detecting delirium in PICU patients, four screening tools demonstrated the following pooled diagnostic accuracy:&nbsp;</div> <div> <ul> <li><strong>Cornell Assessment of Pediatric Delirium (CAPD):</strong> sensitivity 0.95 and specificity 0.81;</li> <li><strong>Pediatric Confusion Assessment Method for the ICU (pCAM-ICU): </strong>sensitivity 0.73 and specificity 0.98;</li> <li><strong>Preschool Confusion Assessment Method for the ICU (psCAM-ICU): </strong>sensitivity 0.84 and specificity 0.90; and</li> <li><strong>Pediatric Anesthesia Emergence Delirium (PAED) scale:</strong> sensitivity and specificity not estimated due to an overall lack of studies (n=3).</li> </ul> <div>While the authors suggest caution when interpreting these findings, the CAPD showed greater sensitivity, increased assessment feasibility, and applicability across all pediatric age groups compared to the pCAM-ICU and psCAM-ICU.</div> <div>&nbsp;</div> <div>Limitations of this review include the variation between the assessment tools, the unequal number of study participants, and the lack of sufficient information across studies resulting in an unclear risk of bias. Additional research is needed to investigate the diagnostic accuracy of the PAED for PICU patients.</div> </div>