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Table 3 Diagnostic test performance of each CAM-IMC item for diagnosis of postoperative delirium (POD) compared to reference standard, analyzed in full cohort, cognitively impaired patients, and those aged ≥ 65 years

From: Disorientation as a delirium feature in non-intubated patients: development and evaluation of diagnostic accuracy of the ‘Confusion Assessment Method for Intermediate Care Unit’ (CAM-IMC) - a prospective cohort study

 

Sensitivity

Specificity

Positive

Negative

Positive

Negative

AUROC

(95% CI)

(95% CI)

Predictive Value

(95% CI)

Likelihood-Ratio

(95% CI)

Whole cohort (n = 624)

       

Acute change/fluctuation

0.83

(0.71–0.92)

0.81

(0.77–0.84)

0.29

(0.22–0.37)

0.98

(0.96–0.99)

4.28

(3.49–5.25)

0.21

(0.11–0.38)

0.82

(0.77–0.87)

Altered level of consciousness

0.35

(0.23–0.49)

0.89

(0.86–0.92)

0.23

(0.15–0.34)

0.94

(0.91–0.95)

3.23

(2.10–4.98)

0.73

(0.60–0.89)

0.62

(0.56–0.69)

Inattention*

0.83

(0.70–0.92)

0.99

(0.98-1.00)

0.90

(0.78–0.97)

0.98

(0.97–0.99)

94.64

(39.21-228.43)

0.17

(0.09–0.31)

0.91

(0.86–0.96)

Disorientation

0.80

(0.66–0.89)

0.99

(0.97–0.99)

0.86

(0.73–0.94)

0.98

(0.97–0.99)

64.84

(30.68-137.06)

0.21

(0.12–0.35)

0.89

(0.84–0.95)

Cognitive impairment (n = 133)

       

Acute change/fluctuation

0.82

(0.60–0.95)

0.76

(0.67–0.83)

0.40

(0.26–0.56)

0.95

(0.89–0.99)

3.36

(2.29–4.93)

0.24

(0.10–0.59)

0.79

(0.70–0.88)

Altered level of consciousness

0.23

(0.08–0.45)

0.91

(0.84–0.96)

0.33

(0.12–0.62)

0.86

(0.78–0.91)

2.52

(0.96–6.66)

0.85

(0.67–1.07)

0.57

(0.48–0.66)

Inattention

0.86

(0.65–0.97)

1.00

(0.97-1.00)

1.00

(0.82-1.00)

0.97

(0.93–0.99)

Inf

(NaN-Inf)

0.14

(0.05–0.39)

0.93

(0.86-1.00)

Disorientation

0.95

(0.77-1.00)

0.98

(0.94-1.00)

0.91

(0.72–0.99)

0.99

(0.95-1.00)

52.98

(13.38-209.82)

0.05

(0.01–0.31)

0.97

(0.92-1.00)

Age ≥ 65 years (n = 398)

       

Acute change/fluctuation

0.85

(0.72–0.94)

0.77

(0.72–0.81)

0.34

(0.25–0.43)

0.97

(0.95–0.99)

3.69

(2.95–4.62)

0.19

(0.10–0.38)

0.81

(0.76–0.87)

Altered level of consciousness

0.38

(0.24–0.53)

0.87

(0.83–0.90)

0.29

(0.18–0.41)

0.91

(0.87–0.94)

2.92

(1.85–4.60)

0.72

(0.57–0.90)

0.62

(0.55–0.69)

Inattention*

0.81

(0.67–0.91)

0.99

(0.97-1.00)

0.88

(0.75–0.96)

0.97

(0.95–0.99)

56.60

(23.44-136.62)

0.19

(0.11–0.35)

0.90

(0.84–0.95)

Disorientation

0.88

(0.75–0.95)

0.98

(0.96–0.99)

0.86

(0.73–0.94)

0.98

(0.96–0.99)

43.75

(20.85–91.80)

0.13

(0.06–0.27)

0.95

(0.93–0.98)

  1. Abbreviations: n = number of examinations. CAM-IMC = Confusion-Assessment-Method for Intermediate Care. AUROC = Area Under the Receiver Operating Characteristic Curve. CI = Confidence Interval. NaN = ’Not a Number’. Inf = ’infinity’
  2. CI for Sensitivity, Specificity, Positive/Negative Predictive Value Positive/Negative Likelihood-Radio was calculated using Clopper-Pearson-Method; CI for AUROC was calculated using DeLong-Method
  3. Cut-Off for ANANASBAUM-test was three or more errors. Cut-Off for Disorientation was two or more errors. RASS ≠ 0 and disorientation are binary
  4. * One Patient with missing sub-examination for this item
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BMC Anesthesiology

ISSN: 1471-2253

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