The Withdrawal Assessment Tool-1 (WAT-1) has been validated for assessing iatrogenic withdrawal syndrome in critically ill children receiving mechanical ventilation, but little is known about this syndrome in critically ill adults.To evaluate the validity and reliability of the WAT-1 in critically ill adults.A prospective, observational, open-cohort pilot study of critically ill adults receiving mechanical ventilation and regular administration of opioids for at least 72 hours. Patients were assessed for withdrawal twice daily on weekdays and once daily on weekends using the WAT-1 after an opioid weaning episode. The presence of iatrogenic withdrawal syndrome was evaluated once daily using modified Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria. All evaluations were blinded and performed independently. The criterion validity of the WAT-1 and the interrater reliability for WAT-1 and DSM-5 evaluations were determined.During 8 months, 52 adults (median age, 51.5 years) were enrolled. Eight patients (15%) had at least 1 positive assessment during their intensive care unit stay using the DSM-5, compared with 19 patients (37%) using the WAT-1. The overall sensitivity of the WAT-1 was 50%, and its specificity was 65.9%. Agreement between WAT-1 and DSM-5 assessments was poor (κ = 0.102). The interrater reliability for the WAT-1 was 89.1% and for the DSM-5 was 90.1%.Despite showing reliability, the WAT-1 is not a valid tool for assessing the presence of iatrogenic withdrawal syndrome in adults.

Anissa Capilnean

Amanda Martone

Vlad A Rosu

Patricia R Sandu

Paul Murgoi

Anne Julie Frenette

David Williamson

Annie Lecavalier

Dev Jayaraman

Philippe Rico

Patrick Bellemare

Céline Gélinas

Marc M Perreault

American Journal of Critical Care

美国重症监护杂志 (AJCC) 的编辑邀请作者提交原始手稿，描述与重症和急性病患者护理相关的所有专业的调查、进展或观察。鼓励合作实践和研究的论文。稿件将被考虑，但前提是它们尚未在其他地方发表并且仅提交给 AJCC。

The editorial team of the American Journal of Critical Care invites authors to submit original manuscripts that describe investigations, advancements, or observations related to the care of critically ill and acutely ill patients. We encourage papers that promote collaborative practice and research. Manuscripts will be considered only if they have not been published elsewhere and are submitted exclusively to this journal.

美国重症监护杂志 (American Journal of Critical Care) 编辑诚邀作者提交原创手稿，内容涉及重症和急性病患者护理相关的各类研究、进展或观察。我们鼓励提交合作实践和研究的论文。所有稿件必须为未在其他地方发表且仅提交给本杂志。

Validation of the Withdrawal Assessment Tool–1 in Adult Intensive Care Patients

成人重症监护患者戒断评估工具-1的验证

Category	Quartile
医学	3
医学, 护理	3
医学, 危重病医学	4

Validation of the Withdrawal Assessment Tool–1 in Adult Intensive Care Patients

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