Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients
Prospective evaluation of the Sedation-Agitation Scale for adult critically ill patients
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DOI：
10.1097/00003246-199907000-00022
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发表时间：
1999-07-01
影响因子：
8.8
通讯作者：
Fraser, GL
中科院分区：
文献类型：
--
作者：
Riker, RR;Picard, JT;Fraser, GL
目的：评估成人重症监护病房（ICU）患者躁动和镇静的主观量表很少进行有效性或可靠性测试，我们修订并前瞻性测试了镇静躁动量表（SAS）的评分者间信度，并将其与Ramsay量表和Harris量表进行比较，以测试结构效度。设计：一个方便的ICU患者样本同时独立地由成对的经过培训的评估者使用修订的SAS、Ramsay和Harris量表进行检查。多学科34床ICU在一个非大学，学术医疗center.Patients：45 ICU患者（外科和内科）进行了检查，共69倍的evaluatorpairs. Measures和主要结果：平均患者年龄为63.2岁，36%是女性，71%插管。当使用SAS进行分类时，45%的人焦虑或激动（SAS 5至7），26%的人平静（SAS 4），29%的人镇静（SAS 1至3）。SAS评分者间相关性较高（r（2）= .83; P < .001），评分者间一致性的加权Kappa评分为0.92（p < .001），在41项Ramsay评分为1的评估中，49%的SAS评分为6，41%的SAS评分为5，5%的SAS评分为4，2%的SAS评分为3或7，SAS与Ramsay（r（2）= .83; p < .001）和Harris（r（2）= .86; p < .001）量表高度相关。结论：SAS既可靠在评估成人ICU患者的激越和镇静方面，该量表具有较高的一致性和有效性（与Harris和Ramsay量表高度相关）。SAS提供了额外的信息，分层搅拌分为三类（相比之下，一个拉姆齐量表），而不牺牲有效性或可靠性。
Objective: Subjective scales to assess agitation and sedation in adult intensive care unit (ICU) patients have rarely been tested for validity or reliability, We revised and prospectively tested the Sedation-Agitation Scale (SAS) for interrater reliability and compared it with the Ramsay scale and the Harris scale to test construct validity.Design:A convenience sample of ICU patients was simultaneously and independently examined by pairs of trained evaluators by using the revised SAS, Ramsay, and Harris Scales.Setting: Multidisciplinary 34-bed ICU in a nonuniversity, academic medical center.Patients: Forty-five ICU patients (surgical and medical) were examined a total of 69 times by evaluator pairs.Measurements and Main Results:The mean patient age was 63.2 yrs, 36% were female, and 71% were intubated. When classified by using SAS, 45% were anxious or agitated (SAS 5 to 7), 26% were calm (SAS 4), and 29% were sedated (SAS 1 to 3). Interrater correlation was high for SAS (r(2) = .83; p < .001) and the weighted kappa score for interrater agreement was 0.92 (p < .001), Of 41 assessments scored as Ramsay 1, 49% scored SAS 6, 41% were SAS 5, 5% were SAS 4, and 2% each were SAS 3 or 7, SAS was highly correlated with the Ramsay (r(2) = .83; p < .001) and Harris (r(2) = .86; p < .001) scales.Conclusions: SAS is both reliable (high interrater agreement) and valid (high correlation with the Harris and Ramsay scales) in assessing agitation and sedation in adult ICU patients. SAS provides additional information by stratifying agitation into three categories (compared with one for the Ramsay scale) without sacrificing validity or reliability.