Prospective validation of Sophia observation withdrawal symptoms: A paediatric delirium scale in critically ill children in Denmark

Background: Paediatric delirium (PD) is increasingly recognised as a common disorder in critically ill children with a reported prevalence ranging from 9% to 66%. We validated the PD component of the Sophia Observation withdrawal Symptoms -Paediatric Delirium (SOS -PD) scale in a Danish setting to provide increased awareness and reliable identi fication of this critical condition, thereby paving the way for improved pathways to targeted delirium care. Objective: The objectives of this study were to criterion validate the PD component of the SOS -PD screening tool by comparing blinded psychiatric and nurse assessments and to estimate the prevalence of delirium in critically ill children in a Danish context. Methods: A prospective observational study was performed on critically ill children aged between 3 m and 18 y, admitted to an intensive care unit, with a hospital stay of 48 h or more. Assessments took place on a fixed weekday over an 18 -month period. To test accuracy and criterion validity, bedside nurses ' SOS -PD assessments were compared to the reference standard, a diagnostic assessment performed by a child psychiatrist according to the Diagnostic and Statistical Manual -V criteria by use of the Vanderbilt Assessment of Delirium in Infants and Children. Results: We included 141 children in the study, 30 (21%) of whom were diagnosed with delirium by the child psychiatrist. The accuracy of the delirium diagnosis was 93.6% (95% con fidence interval [CI]: 88.3 -97.1) among the nurses ' SOS -PD assessments compared to the reference standard. The SOS -PD demonstrated a high sensitivity of 83.3% (95% CI: 65.3-94.4) and a high speci ficity of 96.4% (95% CI: 91.0-99.0) with five false -negative and four false -positive cases. Conclusion: The PD component of the SOS -PD tool has good accuracy and validity for assessments performed by nurses compared to a child psychiatrist's diagnosis in critically ill children in a Danish setting. We recommend the use of the SOS -PD instrument in clinical practice. (c) 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.