关键词: 谵妄；重症监护室；3分钟谵妄诊断量表；灵敏度；特异度

Abstract: Objective: To evaluate the reliability and validity of the Chinese version of 3-Minute Diagnostic Interview for CAM-defined Delirium (3D-CAM) for delirium assessment in ICU patients and its applicability. Methods: We selected 150 ICU patients in the First Affiliated Hospital of Nanchang University from September to October 2019 as the research participants by convenience sampling method, and chose DSM-V as the gold standard to test the validity of 3D-CAM in delirium assessment of ICU patients. Two nurses independently evaluated 55 randomly selected patients with 3D-CAM, and using the inter-evaluator reliability to test their reliability. Results: Delirium was diagnosed with a positive rate of 41.3% by DSM-V, while by 3D-CAM, the positive rate was 38.0%, the Kappa was 0.736 (P<0.01). Compared with gold standard, the sensitivity of 3D-CAM was 87.7% (95%CI 75.5%-94.5%), specificity was 87.1% (95%CI 78.2%-92.9%), PPV was 80.6% (95%CI 68.3%-89.2%), NPV was 92.0% (95%CI 83.8%-96.5%). The reliability study included 55 patients, and the overall consistency of Kappa among raters was 0.845 (P<0.001), the consistent Kappa values of the four diagnostic features (acute onset or fluctuation change, inattention, confusion of thinking and change of consciousness level) were 0.777, 0.809, 0.791 and 0.829 (P<0.001). Conclusion: 3D-CAM has good reliability and validity in delirium assessment of ICU patients. It is characterized by no need for special training, quick assessment and high sensitivity, and is suitable for medical staff with non-psychiatric background.

Key words: delirium; ICU; 3-Minute Diagnostic Interview for CAM-defined Delirium; sensitivity; specificity