Author:
Hong Hong,Guo Chao,Liu Zhi-Hua,Wang Bo-Jie,Zhou Shu-Zhe,Mu Dong-Liang,Wang Dong-Xin
Abstract
Abstract
Background
Cornell assessment of pediatric delirium (CAPD) showed advantage in diagnosis of pediatric delirium in Chinese critically ill patients. But its performance in surgical patients is still unclear. The present study was designed to validate the diagnostic performance of CAPD in surgical pediatric patients.
Methods
This is a prospective validation study. Pediatric patients who underwent selective surgery and general anesthesia were enrolled. Primary outcome was the incidence of delirium within postoperative three days. CAPD Chinese version was used to evaluate if the patient had delirium one time per day. At the meantime, a psychiatrist employed Diagnostic and Statistical Manual of Mental Disorders fifth edition to diagnose delirium, which was the “gold standard”, and the result was considered as reference standard. Sensitivity, specificity and area under receiver operating characteristic (ROC) curve were calculated to investigate the performance of CAPD.
Results
A total of 170 patients were enrolled. Median age was 4 years old. As diagnosed by psychiatrist, 23 (13.5 %) patients experienced at least one episode of delirium during the follow-up period. When diagnostic threshold was set at 9, CAPD showed the optimal sensitivity (87.0 %, 95 %CI 65.3 %-96.6 %) and specificity (98.0 %, 95 %CI 93.7 %-99.5 %) in comparison with other diagnostic thresholds. ROC analysis showed that CAPD was a good delirium assessment instrument with area under curve of 0.911 (95 % CI 0.812 to 1.000, P < 0.001). Agreement between CAPD and reference standard was 0.849 (Kappa coefficient, P < 0.001).
Conclusions
This study found that Cornell assessment of pediatric delirium could be used as an effective instrument in diagnosis of delirium in pediatric surgical patients.
Trial registration
www.chictr.org.cn Identifier: ChiCTR-DDD-17,012,231, August 3, 2017.
Funder
National Key R&D Program of China
Youth Clinical Research Project of Peking University First Hospital
Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology, and Child Health
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