中文版康奈尔儿童谵妄量表在NICU新生儿中的应用

Application of the Chinese version of Cornell Assessment of Pediatric Delirium Scale in NICU newborns

目的明确中文版康奈尔儿童谵妄量表(CAPD)对新生儿重症监护病房(NICU)新生儿谵妄筛查的适用性。方法采用便利抽样法,选取2021年3月—2022年5月在浙江省诸暨市妇幼保健院NICU住院的210例患儿作为研究对象,以美国精神疾病诊断标准(第五版)(DSM-Ⅴ)为金标准,检验中文版CAPD对NICU新生儿谵妄评估的诊断性效度。结果本研究最终纳入患儿189例,经DSM-Ⅴ诊断发生谵妄患儿43例,发生率为22.75%(43/189);不同胎龄、日龄、性别、疾病诊断的NICU新生儿谵妄发生情况比较,差异无统计学意义(P>0.05)。中文版CAPD与DSM-Ⅴ相比,两者的结果一致性Kappa值为0.72(P<0.01);当CAPD诊断阈值取15分时,所得的敏感度为86.01%,特异度为86.30%,此时约登指数最大为0.723。结论中文版CAPD用于NICU新生儿谵妄评估的诊断效度较好,能够为新生儿谵妄评估提供可靠的工具支持。

Objective To clarify the applicability of the Chinese version of Cornell Assessment of Pediatric Delirium Scale(CAPD)for neonatal delirium screening in Neonatal Intensive Care Units(NICU).MethodsFrom March 2021 to May 2022,convenience sampling was used to select 210 newborns admitted to NICU at Zhuji Maternal and Child Health Care Hospital in Zhejiang Province as the study subject.This study used the American Diagnostic and Statistical Manual of Mental Disorders-V(DSM-V)as the gold standard to test the diagnostic validity of the Chinese version of CAPD in the assessment of neonatal delirium in NICU.ResultsThis study ultimately included 189 newborns.A total of 43 newborns with delirium were diagnosed by DSM-V,with an incidence rate of 22.75%(43/189).There was no statistically significant difference in the incidence of neonatal delirium among newborns with different gestational age,day age,gender,and disease diagnosis(P>0.05).Compared with DSM-V,the consistency Kappa value between two results of scales was 0.72(P<0.01).When the CAPD diagnostic threshold was set at 15,the sensitivity of the Chinese version of CAPD was 86.01%,the specificity was 86.30%,and the maximum Youden index obtained was 0.723.ConclusionsThe diagnostic validity of the Chinese version of CAPD for neonatal delirium assessment in NICU is good,and it can provide reliable tool support for neonatal delirium assessment.