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Cornell assessment effective for diagnosing delirium in pediatric patients: Study
![Cornell assessment effective for diagnosing delirium in pediatric patients: Study Cornell assessment effective for diagnosing delirium in pediatric patients: Study](https://medicaldialogues.in/h-upload/2020/03/11/750x450_125390-delirium.webp)
According to recent research, it has been found out that Cornell assessment of pediatric delirium could be used as an effective instrument in the diagnosis of delirium in pediatric surgical patients, as published in the BMC Pediatrics Journal.
Cornell assessment of pediatric delirium (CAPD) showed an advantage in the diagnosis of pediatric delirium in Chinese critically ill patients. But its performance in surgical patients is still unclear.
Hence, Hong Hong and colleagues from the Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China conducted the present study to validate the diagnostic performance of CAPD in surgical pediatric patients.
The authors carried out a prospective validation study on a total of 170 pediatric patients who underwent selective surgery and general anesthesia. The primary outcome was the incidence of delirium within postoperative three days. CAPD the Chinese version was used to evaluate if the patient had delirium one time per day.
In the meantime, a psychiatrist employed the Diagnostic and Statistical Manual of Mental Disorders fifth edition to diagnose delirium, which was the "gold standard", and the result was considered as the reference standard. Sensitivity, specificity and area under receiver operating characteristic (ROC) curve were calculated to investigate the performance of CAPD.
The following key findings were highlighted-
- As diagnosed by a psychiatrist, 23 (13.5 %) patients experienced at least one episode of delirium during the follow-up period.
- When the diagnostic threshold was set at 9, CAPD showed the optimal sensitivity (87.0 %, 95 %CI 65.3 %-96.6 %) and specificity (98.0 %, 95 %CI 93.7 %- 99.5 %) in comparison with other diagnostic thresholds.
- ROC analysis showed that CAPD was a good delirium assessment instrument with area under curve of 0.911 (95 % CI 0.812 to 1.000, P < 0.001).
- Agreement between CAPD and reference, the standard was 0.849 (Kappa coefficient, P < 0.001).
Therefore, the authors concluded that "Cornell assessment of pediatric delirium could be used as an effective instrument in the diagnosis of delirium in pediatric surgical patients. When the cutoff point was set at 9, the instrument showed the best diagnostic performance."
The researchers further added that this result provides strong evidence to facilitate delirium assessment in surgical pediatric patients. As a single center cohort study, our result needs to be further verified by multicenter trials.
BDS, MDS( Pedodontics and Preventive Dentistry)
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751