Cited by 1,487Intensive Care Unit Cognitive DisordersAlcoholism and Thiamine DeficiencyTraumatic Brain Injury Research

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Intensive Care Delirium Screening Checklist: evaluation of a new screening tool

Bergeron, N., Dubois, M.-J., Dumont, M., Dial, S., Skrobik, Y.·2001·Intensive Care Medicine

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Abstract

Objective Delirium in the intensive care unit is poorly defined. Clinical evaluation is difficult in the setting of unstable, often intubated patients. A screening tool may improve the detection of delirium.Method We created a screening checklist of eight items based on DSM criteria and features of delirium: altered level of consciousness, inattention, disorientation, hallucination or delusion, psychomotor agitation or retardation, inappropriate mood or speech, sleep/wake cycle disturbance, and symptom fluctuation. During 3 months, all patients admitted to a busy medical/surgical intensive care unit were evaluated, and the scale score was compared to a psychiatric evaluation.Results In 93 patients studied, 15 developed delirium. Fourteen (93%) of them had a score of 4 points or more. This score was also present in 15 (19%) of patients without delirium, 14 of whom had a known psychiatric illness, dementia, a structural neurological abnormality or encephalopathy. A ROC analysis was used to determine the sensitivity and specificity of the screening tool. The area under the ROC curve is 0.9017. Predicted sensitivity is 99% and specificity is 64%.Conclusion This study suggests that the Intensive Care Delirium Screening Checklist can easily be applied by a clinician or a nurse in a busy critical care setting to screen all patients even when communication is compromised. The tool can be utilized quickly and helps to identify delirious patients. Earlier diagnosis may lead to earlier intervention and better patient care.

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Orexin receptor antagonists versus antipsychotics for the management of delirium in intensive care unit patients with cardiovascular disease: A retrospective observational study
Nakamura, T., Yoshizawa, T., Toya, R., Terasawa, M., Takahashi, K., Kitazawa, K., Suzuki, K., Sasayama, D., & Washizuka, S. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.06.019 · Cited by 8
Delirium in the critically ill patient
Lorenzo, M., Aldecoa, C., & Rico, J. D. (2013) · Trends in Anaesthesia and Critical Care · doi:10.1016/j.tacc.2013.05.005 · Cited by 8
Of Delirium and Sedation
Takala, J. A. (2014) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201401-0195ed · Cited by 8
Caring for Dying Patients in the Intensive Care Unit
Campbell, M. (2015) · AACN Advanced Critical Care · doi:10.4037/nci.0000000000000077 · Cited by 8
QTc prolongation after haloperidol administration in critically ill patients post cardiovascular surgery: A cohort study and review of the literature
Ibrahimi, B., Böettger, S., Schubert, M., Béttex, D., & Rudiger, A. (2020) · Palliative & Supportive Care · doi:10.1017/s1478951520000231 · Cited by 9
“Each item is rated on the patient’s behavior over the previous 24 h, and the inter-rater reliability between intensive care staff was considered adequate (Bergeron et al., 2001).”
Background
Efficacy of Orexin Receptor Antagonist for Delirium after Coronary Artery Bypass Grafting Compared with Melatonin Receptor Agonist
Tamura, K., Maruyama, T., & Sakurai, S. (2020) · Journal of Coronary Artery Disease · doi:10.7793/jcad.26.20-00017 · Cited by 8
The Prognostic Value of Brain Dysfunction in Critically Ill Patients with and without Sepsis: A Post Hoc Analysis of the ICON Audit
Crippa, I. A., Taccone, F. S., Wittebole, X., Martín‐Loeches, I., Schroeder, M. E., François, B., Kotfis, K., Ñamendys-Silva, S. A., Forceville, X., Solé‐Violán, J., et al. (2021) · Brain Sciences · doi:10.3390/brainsci11050530 · Cited by 8
“Moreover, GCS is a measure of global brain dysfunction and other clinical scales, such as the Confusion Assessment Method for the ICU (CAM-ICU) or Intensive Care Delirium Screening Checklist (ICDSC), may be more accurate to assess mild alteration or transient changes in brain function in critically ill patients [16,17…”
Background
Fallstricke in der Diagnostik des Delirs
Nydahl, P., Guenther, U., Hansen, H.-C., et al. (2021) · Medizinische Klinik - Intensivmedizin und Notfallmedizin · doi:10.1007/s00063-021-00846-9 · Cited by 8
Delirium in the Intensive Care Unit
Ely, E. W. (2005) · Springer eBooks · doi:10.1007/0-387-26272-5_60 · Cited by 8
Sepsis-associated Encephalopathy
Siami, S., Polito, A., & Sharshar, T. (2009) · Springer eBooks · doi:10.1007/978-3-540-92276-6_74 · Cited by 8
The Effects of Dexmedetomidine on Postoperative Delirium in Adult Cardiac Surgical Patients: A Bayesian Meta‐Analysis and Trial Sequential Analysis
Keith, N., Harrowell, L., Alexandrou, E., Åneman, A., & Frost, S. A. (2025) · Acta Anaesthesiologica Scandinavica · doi:10.1111/aas.70069 · Cited by 9
“Screening tools to identify the incidence of delirium included CAM [58], CAM-ICU [6], ICDSC [7], Delirium Rating Scale (DRS) [58], CAM-Severity (CAM-S) [59], Motor Activity Assessment Scale (MAAS) [60], Mini-Mental State Exam (MMSE) [61] and Richmond Agitation Sedation Scale (RASS) [62].”
Barriers and facilitators to the delivery of delirium care in intensive care units: an analysis informed by the Theoretical Domains Framework
Parslow, R. M., Gibbison, B., Pufulete, M., Rowan, K., Moore, A. J., & the OPTIC Study Group (2025) · Anaesthesia · doi:10.1111/anae.70017 · Cited by 9
Identifying the relationship between delirium and falls
Leah, V., & Ngwu, L. (2023) · Nursing Older People · doi:10.7748/nop.2023.e1418 · Cited by 7
The efficacy and safety of haloperidol for the treatment of delirium in critically ill patients: a systematic review and meta-analysis of randomized controlled trials
Huang, J. V., Zheng, H., Zhu, X., Zhang, K., & Ping, X. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1200314 · Cited by 7
Effect of pharmacist-led intervention protocol on preventing postoperative delirium after elective cardiovascular surgery
Asai, Y., Yanagawa, T., & Takahashi, M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0292786 · Cited by 7
“Delirium was defined using the Intensive Care Delirium Screening Checklist (ICDSC) as an ICDSC score� 4 (sensitivity, 99%; specificity, 64%) [12].”
Method
Physicians’ beliefs and perceived importance of traumatic brain injury-associated agitation in critically ill patients: a survey of Canadian intensivists
Saavedra‐Mitjans, M., Frenette, A. J., McCREDIE, V. A., et al. (2023) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-023-02666-1 · Cited by 7
Pharmacologic Treatment Strategies for Delirium in Hospitalized Adults: Past, Present, and Future
Devlin, J. W. (2024) · Seminars in Neurology · doi:10.1055/s-0044-1791246 · Cited by 8
“…Regular delirium assessment by bedside clinicians using a validated assessment tool (e.g., CAM, 3D-CAM, CAM-ICU, or ICDSC) is a foundational component of all hospital delirium reduction efforts, 33 – 36 is recommended by multiple guidelines, 9,10,21,37 – 39 and is associated with reduced mortality.”
Triglyceride-glucose index: a novel prognostic marker for sepsis-associated encephalopathy severity and outcomes
Shi, X., Xu, L., Ren, J., Jing, L., Wei, K., & Qin, L. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1468419 · Cited by 6
Accurate Identification of Delirium in the ICU: Problems with Translating the Evidence in the Real-Life Setting
Patel, S. B., & Kress, J. P. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201106-0988ed · Cited by 7
Intensive Care Unit Delirium, Clinical Observations, and Patients' Statements
Granberg‐Axéll, A., & Bergbom, I. (2020) · Dimensions of Critical Care Nursing · doi:10.1097/dcc.0000000000000424 · Cited by 7

Authors: Bergeron, N., Dubois, M.-J., Dumont, M., Dial, S., & Skrobik, Y.
Affiliations: Hôpital Maisonneuve-Rosemont (CA)
McGill University (CA)
Corresponding author: Skrobik, Y.
ORCID: Bergeron, N.
Skrobik, Y.
Venue: Intensive Care Medicine
Publisher: Springer Science and Business Media LLC
Published: 2001-04-20
Volume: 27
Issue: 5
Pages: 859-864
ISSN: 0342-4642 (ISSN-L)
1432-1238
DOI: 10.1007/s001340100909
OpenAlex: W2143617649
Cited by: 1,487
References: 0
Citations by year: 2026: 78 · 2025: 85 · 2024: 96 · 2023: 94 · 2022: 80 · 2021: 96 · 2020: 110 · 2019: 78 · 2018: 70 · 2017: 79 · 2016: 66 · 2015: 64 · 2014: 60 · 2013: 74 · 2012: 73
FWCI: 6.08
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Intensive Care Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Health Sciences › Medicine › Clinical Neurology › Alcoholism and Thiamine Deficiency
Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Keywords: delirium, intensive care unit, delirium screening, screening checklist, intensive care, altered level of consciousness, psychomotor agitation, sleep-wake disturbances, sensitivity and specificity, early diagnosis
MeSH terms: Adult, Aged, Aged, 80 and over, Critical Care, Delirium, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, ROC Curve, Sensitivity and Specificity, Critical Illness, APACHE

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Intensive Care Delirium Screening Checklist: evaluation of a new screening tool

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