Correlation Between the Richmond Agitation Sedation Scale and Neelon Champagne Confusion Scale in Critical Care Units in an Indian Suburban Tertiary Care Hospital

V. Vasanth Kumar¹ , N. Revathi² , K. Sai Sriram³

Section:Research Paper, Product Type: Journal-Paper
Vol.6 , Issue.9 , pp.70-76, Sep-2020

Online published on Sep 30, 2020

Copyright © V. Vasanth Kumar, N. Revathi, K. Sai Sriram . This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
 

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Abstract :
Psychological distress associated with delirium is condition commonly reported in intensive care unit patients, characterized by various environmental, medical and medication related factors. Delirium usually presents as a group of symptoms with an acute onset and a fluctuating course which have been categorized into cognitive and behavioural groups. This is a prospective observational cohort study conducted at Gleneagles Aware Global Hospitals, L.B Nagar, Hyderabad. for a study period of six months. 200 patients admitted with the hospitalization history of more than 24 hours in critical care units were enrolled as study population. Patient data collection form, contains the socio-demographic details of the patients and Observational study Informed Consent form was prepared for patients understanding for agreeing to participate in the study. The correlation and delirium assessment were done using Richmond Agitation Sedation Scale (RASS) Worksheet and Neelon Champagne Confusion Scale (NEECHAM). In this study, it is concluded that the majority of the delirious patients were assessed to be mild to moderate sedated (96.1%), followed by agitated to irritated (100%) when correlated with P-value <0.0001 (clinically significant). Out of 200 study population, only 126 patients passed the NEECHAM screening criteria. According to NEECHAM scoring, majority were assessed to be moderately confused 95.4% (16-20), followed by severe confusion 100% (11-15) when correlated with delirium (P-value <0.0001), indicating ICU patients are at risk of developing delirium (temporary) within the ICU during the course of hospitalization, which resolves with relevant patient orientated management. From the ?-value –0.7003, there is a significant negative correlation between NEECHAM score and RASS score. When ? is -1, the relationship is said to be perfectly negatively correlated. This negative correlation signifies that as the NEECHAM score decreases, the RASS increase (and vice versa), indicating two different criteria of assessment for the same perceptions of delirium developing in the ICUs are possible.

Key-Words / Index Term :
Correlation, delirium, ICUS, prospective, observational, evidence-based study, CAM-ICU, NEECHAM, intensive care unit, critical care, terminal care

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