Enfermeria intensivaJun 10, 2014

Agreement between two delirium rating scales in ICU patients after heart surgery

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 31, 2026

Abstract

The incidence of delirium was 8.4% using the CAM-ICU scale and 16.8% using the Nursing Delirium Screening Scale (NDSS).

Concordance between CAM-ICU and NDSS was assessed, yielding a Kappa index of 0.541.
This indicates a low level of agreement between the two scales in detecting delirium.
Both scales were administered to 106 patients, resulting in a total of 214 evaluations.
The CAM-ICU scale is recommended for use in postoperative cardiac surgery, but should not be replaced by NDSS.

Simplified

OBJECTIVE: To evaluate concordance between the scale of delirium assessment CAM-ICU and the Nursing Delirium Screening Scale (NDSS) in postoperative cardiac surgery.

MATERIAL AND METHODS: Prospective study in tertiary hospital with consecutive selection of patients after cardiac surgery. During the stay in the Intensive Care Unit, CAM-ICU and NDSS were administered by the same researcher. For demographic and preoperative risk factors of delirium, descriptive statistical analysis was performed. Concordance was assessed using kappa index.

RESULTS: 106 patients were included, performing 214 evaluations. Incidence of delirium with the CAM-ICU scale was of 8.4%, and of 16.8% with NDSS. The concordance expressed by the index Kappa was of 0.541.

CONCLUSIONS: The concordance between the CAM-ICU scale and the NDSS in the postoperative cardiac surgery and during the stay in the Intensive Care Unit is low. Currently, the use of the CAM-ICU was recommended in this context, but it must not be replaced for the NDSS.

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Agreement between two delirium rating scales in ICU patients after heart surgery

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