CHART-DEL-ICU — Chart-based Delirium Identification Instrument for the ICU

What this tool is and how to interpret its evidence

CHART-DEL-ICU adapts the established chart-based delirium identification method for critically ill adults. Trained abstractors review the medical record for evidence compatible with delirium and classify the likelihood that an episode occurred. The method is intended for retrospective research, audit and quality improvement when prospective bedside assessment is unavailable; it is not a tool for making real-time decisions about an individual patient.

Krewulak and colleagues evaluated the adaptation in 213 ICU patients who also received prospective delirium assessments. Inter-rater reliability was excellent. At an inclusive threshold the chart method had sensitivity of 66.0% and specificity of 82.1%; discrimination improved when chart findings were combined with routine CAM-ICU or ICDSC results. Hypoactive or poorly documented episodes remain an inherent challenge for record-based methods.

The site already carries CHART-DEL as context, so omission of the ICU adaptation is inconsistent. CHART-DEL-ICU should be a linked version under the same family and excluded from the bedside core count. The page can describe abstraction, four-level judgement, reliability and diagnostic accuracy without reproducing the complete abstraction guide. Users should understand that the quality of documentation constrains the result and that retrospective case finding is not a substitute for contemporaneous clinical assessment.