{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T01:45:48Z","timestamp":1786326348786,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Delirium screening instruments (DSIs) should be used to detect delirium, but they only show moderate sensitivity in patients with neurocritical illness. We explored whether, for these patients, DSI validity is impacted by patient-specific covariates.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data were prospectively collected in a single-center quality improvement project. Patients were screened for delirium once daily using the Intensive Care Delirium Screening Checklist (ICDSC) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Reference was the daily assessment using criteria from the Diagnostic and Statistical Manual, 4th Edition, Text Revision (DSM-IV-TR). In a two-step receiver operating characteristics regression analysis adjusting for repeated measurements, the impact of acute diagnosis of stroke or transient ischemic attack (TIA), neurosurgical intervention, Richmond Agitation Sedation Scale, and ventilation status on test validity was determined.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 181 patients screened, 101 went into final analysis. Delirium incidence according to DSM-IV-TR was 29.7%. For the first complete assessment series (CAM-ICU, ICDSC, and DSM-IV-TR), sensitivity for the CAM-ICU and the ICDSC was 73.3% and 66.7%, and specificity was 91.8% and 94.1%, respectively. Consideration of daily repeated measurements increased sensitivity for the CAM-ICU and ICDSC to 75.7% and 73.4%, and specificity to 97.3% and 98.9%, respectively. Receiver operating characteristics regression revealed that lower Richmond Agitation Sedation Scale levels significantly impaired validity of the ICDSC (<jats:italic>p<\/jats:italic>\u2009=\u20090.029) and the CAM-ICU in its severity scale version (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). Neither acute diagnosis of stroke or TIA nor neurosurgical intervention or mechanical ventilation significantly influenced DSI validity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The CAM-ICU and ICDSC perform well in patients requiring neurocritical care, regardless of the presence of acute stroke, TIA, or neurosurgical interventions. Yet, even very light or moderate sedation can significantly impair DSI performance.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12028-021-01319-9","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T18:21:09Z","timestamp":1628533269000},"page":"452-462","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Influence of Patient-Specific Covariates on Test Validity of Two Delirium Screening Instruments in Neurocritical Care Patients (DEMON-ICU)"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3139-595X","authenticated-orcid":false,"given":"Bj\u00f6rn","family":"Weiss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-3980","authenticated-orcid":false,"given":"Nicolas","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-0495","authenticated-orcid":false,"given":"Claudia D.","family":"Spies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Ullrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Ansorge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1114-3181","authenticated-orcid":false,"given":"Farid","family":"Salih","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3563-3954","authenticated-orcid":false,"given":"Stefan","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8814-1809","authenticated-orcid":false,"given":"Alawi","family":"Luetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,9]]},"reference":[{"issue":"14","key":"1319_CR1","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1001\/jama.291.14.1753","volume":"291","author":"EW Ely","year":"2004","unstructured":"Ely EW, Shintani A, Truman B, et al. 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NP, DU, IA, FS and SW declare that they have no conflicts of interest. CDS reports Grants from Dr\u00e4gerwerk AG & Co. KGaA, Grants from Deutsche Forschungsgemeinschaft\/German Research Society, Grants from Deutsches Zentrum f\u00fcr Luft- und Raumfahrt e. V. (DLR)\/German Aerospace Center, Grants from Einstein Stiftung Berlin\/Einstein Foundation Berlin, Grants from Gemeinsamer Bundesausschuss\/Federal Joint Committee (G-BA), Grants from Inneruniversit\u00e4re Forschungsf\u00f6rderung\/Inner University Grants, Grants from Projekttr\u00e4ger im DLR\/Project Management Agency, Grants from Stifterverband\/Nonprofit Society Promoting Science and Education, Grants from WHOCC, Grants from Baxter Deutschland GmbH, Grants from Cytosorbents Europe GmbH, Grants from Edwards Lifesciences Germany GmbH, Grants from Fresenius Medical Care, Grants from Gr\u00fcnenthal GmbH, Grants from Masimo Europe Ltd., Grants from Pfizer Pharma PFE GmbH, personal fees from Georg Thieme Verlag, Grants from Dr. F. K\u00f6hler Chemie GmbH, Grants from Sintetica GmbH, Grants from Stifterverband f\u00fcr die deutsche Wissenschaft e.V. Philips Grants from Stiftung Charit\u00e9, Grants from AGUETTANT Deutschland GmbH, Grants from AbbVie Deutschland GmbH & Co. KG, Grants from Amomed Pharma GmbH, Grants from InTouch Health, Grants from Copra System GmbH, Grants from Correvio GmbH, Grants from Max-Planck-Gesellschaft zur F\u00f6rderung der Wissenschaften e.V., Grants from Deutsche Gesellschaft f\u00fcr An\u00e4sthesiologie & Intensivmedizin (DGAI), Grants from Stifterverband f\u00fcr die deutsche Wissenschaft e.V.\/Metronic, Grants from Philips Electronics Nederland BV, Grants from BMG, Grants from BMBF, Grants from Deutsche Forschungsgemeinschaft\/ German Research Society, outside the submitted work. In addition, CDS has a patent 10 2014 215 211.9 licensed, a patent 10 2018 114 364.8 licensed, a patent 10 2018 110 275.5 licensed, a patent 50 2015 010 534.8 licensed, a patent 50 2015 010 347.7 licensed, and a patent 10 2014 215 212.7 licensed. AL reports personal fees from Hill-Rom, personal fees from K\u00f6hler Chemie, personal fees from Philips Healthcare, outside the submitted work. In addition, AL has a patent 10 2014 215 211.9 pending, and a patent 10 2014 215 212.7 pending.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}},{"value":"This quality improvement project was performed in adherence to the ethical standards described in the Declaration of Helsinki from 1964 and its later amendments. Scientific publication of the data were approved by the Ethics Committee at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin (EA1\/228\/15), and informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval\/Informed Consent"}}]}}