Background: Delirium in critically ill children is a severe neuropsychiatric disorder which has gained increased attention from clinicians. Early identification of delirium is essential for successful management. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale was developed to detect Paediatric Delirium (PD) at an early stage. Objective: The aim of this study was to determine the measurement properties of the PD component of the SOS-PD scale in critically ill children. Methods: A prospective, observational study was performed in patients aged 3 months or older and admitted for more than 48. h. These patients were assessed with the SOS-PD scale three times a day. If the SOS-PD total score was 4 or higher in two consecutive observations, the child psychiatrist was consulted to assess the diagnosis of PD using the Diagnostic and Statistical Manual-IV criteria as the "gold standard". The child psychiatrist was blinded to outcomes of the SOS-PD. The interrater reliability of the SOS-PD between the care-giving nurse and a researcher was calculated with the intraclass correlation coefficient (ICC). Results: A total of 2088 assessments were performed in 146 children (median age 49 months; IQR 13-140). The ICC of 16 paired nurse-researcher observations was 0.90 (95% CI 0.70-0.96). We compared 63 diagnoses of the child psychiatrist versus SOS-PD assessments in 14 patients, in 13 of whom the diagnosis of PD was confirmed. The sensitivity was 96.8% (95% CI 80.4-99.5%) and the specificity was 92.0% (95% CI 59.7-98.9%). Conclusions: The SOS-PD scale shows promising validity for early screening of PD. Further evidence should be obtained from an international multicentre study.

Additional Metadata
Keywords Assessment tool, Benzodiazepine, Iatrogenic withdrawal syndrome (IWS), Paediatric Delirium, PICU, Sedation
Persistent URL dx.doi.org/10.1016/j.aucc.2017.07.006, hdl.handle.net/1765/101635
Journal Australian Critical Care
Citation
Ista, E, te Beest, H, van Rosmalen, J.M, de Hoog, M, Tibboel, D, van Beusekom, B.S, & van Dijk, M. (2017). Sophia Observation withdrawal Symptoms-Paediatric Delirium scale: A tool for early screening of delirium in the PICU. Australian Critical Care. doi:10.1016/j.aucc.2017.07.006