ICU意识模糊评估量表与重症监护谵妄筛查量表应用效果比较的Meta分析

Comparing CAM-ICU and ICDSC for the screening of delirium in critically ill patients:a meta-analysis

目的 评价ICU意识模糊评估量表(Confusion Assessment Method of Intensive Care Unit,CAM-ICU)和重症监护谵妄筛查量表(Intensive Care Delirium Screening Checklist,ICDSC)对重症患者谵妄发生的应用效果,为重症患者谵妄筛查的工具选择提供依据。方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库、维普数据库、中国生物医学文献数据库从建库至2023年2月24日关于CAM-ICU与ICDSC的诊断试验准确性比较研究。经过文献筛选、文献质量评估、资料提取后,采用Rev Man 5.3软件和Meta-DiSc软件进行数据分析。结果 共纳入10篇研究,CAM-ICU和ICDSC的合并灵敏度分别为0.73和0.77;合并特异度分别为0.93和0.91;合并诊断比值比为37.62和36.95。结论 CAM-ICU与ICDSC在重症患者谵妄筛查中均具有良好的诊断效度;基于谵妄的波动性特点,CAM-ICU可能更适合ICU环境下患者的谵妄评估。

Objective To evaluate the screening efficacy of Confusion Assessment Method of Intensive Care Unit(CAM-ICU)and Intensive Care Delirium Screening Scale(ICDSC)for the occurrence of delirium in critically ill patients,and to provide evidence for the selection of tools for the screening of delirium in critically ill patients.Methods Comparative studies on accuracy of diagnostic tests between CAM-ICU and ICDSC were searched by computer in Pubmed,Web of Science,Embase,The Cochrane Library,CNKI,Wanfang Database,VIP database and Chinese Biomedical Literature database,respectively from the establishment of the database to February 24,2023.After literature screening,literature quality assessment and data extraction,Rev Man 5.3 and meta-DiSc software were used for data analysis.Results A total of 10 studies were included.The combined sensitivity of CAM-ICU and ICDSC were 0.73 and 0.77,respectively.The combined specificity was 0.93 and 0.91.The odds ratios of combined diagnosis were 37.62 and 36.95.Conclusion Both CAM-ICU and ICDSC have good diagnostic validity in screening patients with moderate and severe delirium.However,based on the fluctuation characteristics of delirium,CAM-ICU may be more suitable for delirium assessment in patients in the ICU environment.