Validation of the Greek version of Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)

Objectives: Delirium is associated with the most adverse outcomes in critically ill patients but it is often undiagnosed and untreated. The Confusion Assessment Method for Intensive Care Unit (CAM-ICU) is widely used for delirium assessment. This scale, however, has not been translated and validated into the Greek language. This paper is a report of the translation and validation of the CAM-ICU into Greek.

Research methodology: The applicability and validity of CAM-ICU was tested in two Greek general ICUs. Each patient was included in the study only once. Inter-rater reliability and concurrent validity of both raters compared to the gold standard (DSM-IV) was calculated.

Results: Study sample consisted of 71 patients. Based on psychiatric diagnosis the prevalence of delirium was 33.8%. Compared to the reference standard for diagnosing delirium, the two study raters who used the CAM-ICU had sensitivities of 87.5% and 79.0%, specificities of 91.0% and 87.0%, and good inter-rater reliability (κ=0.75). Cronbach's alpha was 0.84 (95% CI 0.77-0.89). The mean CAM-ICU administration time was 6 minutes and 30 seconds.

Conclusion: CAM-ICU seems to be a valid and reliable instrument for delirium detection in Greek intensive care patients, which can be easily incorporated in every day clinical practice after appropriate training.