This article is part of the supplement: 33rd International Symposium on Intensive Care and Emergency Medicine

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International validation of the delirium prediction model for ICU patients (PREDELIRIC): a multicenter observational study

M van den Boogaard1*, L Schoonhoven2, E Maseda3, C Plowright4, C Jones5, A Luetz6, PV Sackey7, P Jorens8, LM Aitken9, F van Haren10, JG van der Hoeven1 and P Pickkers1

  • * Corresponding author: M van den Boogaard

Author Affiliations

1 Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

2 Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands

3 Hospital Universitario La Paz, Madrid, Spain

4 Medway Maritime Hospital, Kent, UK

5 Whiston Hospital, Prescot, UK

6 Charité - Universitaetsmedizin Berlin, Germany

7 Karolinska University Hospital, Stockholm, Sweden

8 University of Antwerpen, Belgium

9 Princess Alexandra Hospital, Woolloongabba, Australia

10 Canberra Hospital, Canberra, Australia

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Critical Care 2013, 17(Suppl 2):P398  doi:10.1186/cc12336

The electronic version of this article is the complete one and can be found online at:

Published:19 March 2013

© 2013 van den Boogaard et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Delirium is a serious and frequent disorder in ICU patients. The aim of this study was to internationally validate the existing Prediction of Delirium ICU (PREDELIRIC) model to predict delirium in ICU patients.


A prospective multicenter cohort study was performed in eight ICUs in six countries (Table 1). The 10 predictors (age, APACHE II score, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 hours after ICU admission. CAM-ICU was used to identify ICU delirium.

Table 1. PREDELIRIC AUROC of different centers


A total of 2,852 adult ICU patients were screened and 1,824 (64%) were included. Main exclusion reasons were length of stay <1 day (19.1%) and sustained coma (4.1%). Mean ± CAM-ICU compliance was 82 ± 16% and inter-rater reliability 0.87 ± 0.17. Overall delirium incidence was 19.9% (range 27.2%). Despite significant differences between centres on all 10 predictors, the overall area under the receiver operating characteristic curve (AUROC) of the eight centers was 0.77 (95% CI: 0.74 to 0.79).


The overall predictive value of the PREDELIRIC model was good, indicating that the prediction model can now be used internationally.