• Surui Liang, ChauJanita Pak ChunJPCThe Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR., Suzanne Hoi Shan Lo, Liping Bai, Li Yao, and Kai Chow Choi.
• The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
• Nurs Crit Care. 2021 May 1; 26 (3): 176-182.

BackgroundAn intensive care unit (ICU) delirium prediction tool, PREdiction of DELIRium in ICu patients (PRE-DELIRIC), has been developed and calibrated in a multinational project. However, there is a lack of evidence regarding the predictive ability of the PRE-DELIRIC among Chinese ICU patients.AimTo evaluate the predictive validity (discrimination and calibration) of PRE-DELIRIC.DesignThis is a retrospective cohort study.MethodsA retrospective cohort study was conducted. Consecutive participants (a) admitted to the ICU for ≥24 hours, (b) aged ≥18 years, and (c) admitted to the ICU for the first time were included. Ten predictors (age, APACHE-II, urgent and admission category, urea level, metabolic acidosis, infection, coma, sedation, and morphine use) assessed within 24 hours upon ICU admission were assessed. Delirium was assessed using the Confusion Assessment Method for ICU. Outcomes included ICU length of stay and mortality. Discrimination and calibration were determined by the areas under the receiver operating characteristic curve (AUROC), box plot, and calibration plot.ResultsA total of 375 ICU patients were included, with 44.0% of patients being delirious. Delirium was significantly associated with age, PRE-DELIRIC score, ICU length of stay, and mortality. The AUROC was 0.81 (95% confidence interval, 0.77-0.86). The optimal cut-off point identified by max Youden index was 49%. The calibration plot of pooled data demonstrated a calibration slope of 0.894 and an intercept of -0.178.ConclusionsThe PRE-DELIRIC has high predictive value and is suggested to be adopted in ICUs for early initiation of preventive interventions against delirium among high-risk patients.Relevance To Clinical PracticeClinicians can adopt the PRE-DELIRIC among ICU patients to screen patients at high risk of developing delirium. Early initiative interventions could be implemented to reduce the negative impacts of ICU delirium.© 2020 British Association of Critical Care Nurses.

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