Screening and differential diagnosis of delirium in
neurointensive stroke patients

J 2024

Screening and differential diagnosis of delirium in neurointensive stroke patients

BAKOŠOVÁ, Lucia, David KEC, Miroslav ŠKORŇA, René JURA, Zdeněk KUNDRATA et. al.

Basic information

Original name

Screening and differential diagnosis of delirium in neurointensive stroke patients

Authors

BAKOŠOVÁ, Lucia (703 Slovakia, belonging to the institution), David KEC (203 Czech Republic, belonging to the institution), Miroslav ŠKORŇA (203 Czech Republic, belonging to the institution), René JURA (203 Czech Republic, belonging to the institution), Zdeněk KUNDRATA (203 Czech Republic, belonging to the institution), Milena KOŠŤÁLOVÁ (203 Czech Republic, belonging to the institution) and Josef BEDNAŘÍK (203 Czech Republic, belonging to the institution)

Edition

HELIYON, OXFORD, ELSEVIER SCI LTD, 2024, 2405-8440

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.000 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.heliyon.2024.e25918

UT WoS

001184517300001

Keywords in English

Delirium Stroke CAM-ICU ICDSC Nonconvulsive status epilepticus Aphasia

Abstract

V originále

Diagnosing delirium in neurointensive care is difficult because symptoms of delirium, such as inappropriate speech, may be related to aphasia due to primary brain injury. Therefore, validated screening tools are needed. The aim of this study was to compare two Czech versions of already validated screening tools the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) - in a cohort of acute stroke patients. We also aimed to assess the pitfalls of delirium detection in the context of non-convulsive status epilepticus (NCSE). We analysed 138 stroke patients admitted to the neurological intensive care unit (ICU) or stroke unit. According to expert judgement, which was used as the gold standard, 38 patients (27.54%) developed delirium. The sensitivity and specificity of the ICDSC were 91.60% and 95.33%, respectively, and the positive and negative predictive values were 76.76% and 98.54%, respectively. Similarly, the sensitivity and specificity of CAM-ICU were 75.63% and 96.74%, respectively, and the positive and negative predictive values were 79.65% and 95.93%, respectively. We did not detect an episode of NCSE mimicking delirium in any of our stroke patients who were judged to be delirious by expert assessment. Our results suggest that the ICDSC may be a more suitable tool for delirium screening than the CAM-ICU in patients with neurological deficit. NCSE as a mimic of delirium seems to be less common in the acute phase of stroke than previously reported.

Links

MUNI/A/1186/2022, interní kód MU

Name: Diagnostika a patofyziologie neuropatické bolesti a dalších symptomů a komorbidit neurologických onemocnění

Investor: Masaryk University

MUNI/IGA/1309/2020, interní kód MU

Name: Use of ICDSC and CAM-ICU screening tests in neurological patients in the differential diagnosis of delirium and NCSE

Investor: Masaryk University

Citovat

BAKOŠOVÁ, Lucia, David KEC, Miroslav ŠKORŇA, René JURA, Zdeněk KUNDRATA, Milena KOŠŤÁLOVÁ and Josef BEDNAŘÍK. Screening and differential diagnosis of delirium in neurointensive stroke patients. HELIYON. OXFORD: ELSEVIER SCI LTD, 2024, vol. 10, No 4, p. 1-9. ISSN 2405-8440. Available from: https://dx.doi.org/10.1016/j.heliyon.2024.e25918.

@article{2380260,
   author = {Bakošová, Lucia and Kec, David and Škorňa, Miroslav and Jura, René and Kundrata, Zdeněk and Košťálová, Milena and Bednařík, Josef},
   article_location = {OXFORD},
   article_number = {4},
   doi = {http://dx.doi.org/10.1016/j.heliyon.2024.e25918},
   keywords = {Delirium Stroke CAM-ICU ICDSC Nonconvulsive status epilepticus Aphasia},
   language = {eng},
   issn = {2405-8440},
   journal = {HELIYON},
   title = {Screening and differential diagnosis of delirium in neurointensive stroke patients},
   url = {https://www.cell.com/heliyon/pdf/S2405-8440(24)01949-2.pdf},
   volume = {10},
   year = {2024}
}

TY  - JOUR
ID  - 2380260
AU  - Bakošová, Lucia - Kec, David - Škorňa, Miroslav - Jura, René - Kundrata, Zdeněk - Košťálová, Milena - Bednařík, Josef
PY  - 2024
TI  - Screening and differential diagnosis of delirium in neurointensive stroke patients
JF  - HELIYON
VL  - 10
IS  - 4
SP  - 1-9
EP  - 1-9
PB  - ELSEVIER SCI LTD
SN  - 24058440
KW  - Delirium Stroke CAM-ICU ICDSC Nonconvulsive status epilepticus Aphasia
UR  - https://www.cell.com/heliyon/pdf/S2405-8440(24)01949-2.pdf
N2  - Diagnosing delirium in neurointensive care is difficult because symptoms of delirium, such as inappropriate speech, may be related to aphasia due to primary brain injury. Therefore, validated screening tools are needed. The aim of this study was to compare two Czech versions of already validated screening tools the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) - in a cohort of acute stroke patients. We also aimed to assess the pitfalls of delirium detection in the context of non-convulsive status epilepticus (NCSE). We analysed 138 stroke patients admitted to the neurological intensive care unit (ICU) or stroke unit. According to expert judgement, which was used as the gold standard, 38 patients (27.54%) developed delirium. The sensitivity and specificity of the ICDSC were 91.60% and 95.33%, respectively, and the positive and negative predictive values were 76.76% and 98.54%, respectively. Similarly, the sensitivity and specificity of CAM-ICU were 75.63% and 96.74%, respectively, and the positive and negative predictive values were 79.65% and 95.93%, respectively. We did not detect an episode of NCSE mimicking delirium in any of our stroke patients who were judged to be delirious by expert assessment. Our results suggest that the ICDSC may be a more suitable tool for delirium screening than the CAM-ICU in patients with neurological deficit. NCSE as a mimic of delirium seems to be less common in the acute phase of stroke than previously reported.
ER  -

BAKOŠOVÁ, Lucia, David KEC, Miroslav ŠKORŇA, René JURA, Zdeněk KUNDRATA, Milena KOŠŤÁLOVÁ and Josef BEDNAŘÍK. Screening and differential diagnosis of delirium in neurointensive stroke patients. \textit{HELIYON}. OXFORD: ELSEVIER SCI LTD, 2024, vol.~10, No~4, p.~1-9. ISSN~2405-8440. Available from: https://dx.doi.org/10.1016/j.heliyon.2024.e25918.

Detailed Information on Publication Record