Two-stage prediction model for postoperative delirium in patients in the intensive care unit after cardiac surgery

作者：Shining Cai, Hang Cui, Wenyan Pan, Jingjing Li, Xiaolei Lin, Yuxia Zhang · 发表于：European Journal of Cardio-Thoracic Surgery · 年份：2022 · DOI：10.1093/ejcts/ezac573 · 被引用次数：12 · 研究领域：Intensive Care Unit Cognitive Disorders、Nosocomial Infections in ICU、Thermal Regulation in Medicine

OBJECTIVES: Postoperative delirium is a common severe complication in patients in the intensive care unit after cardiac surgery. We developed a two-stage prediction model and quantified the risk of developing postoperative delirium to assist in early prevention before and after surgery. METHODS: We conducted a prospective cohort study and consecutively recruited adult patients after cardiac surgery. The Confusion Assessment Method for patients in the intensive care unit was used to diagnose delirium 5 days postoperatively. The stage I model was constructed using patient demographics, health conditions and laboratory results obtained preoperatively, whereas the stage II model was built on both pre- and postoperative predictors. The model was validated internally using the bootstrap method and externally using data from an external cohort. RESULTS: The two-stage model was developed with 654 patients and was externally validated with 214 patients undergoing cardiac surgery. The stage I model contained 6 predictors, whereas the stage II model included 10 predictors. The stage I model had an area under the receiver operating characteristic curve of 0.76 (95% confidence interval: 0.68-0.81), and the stage II model's area under the receiver operating characteristic curve increased to 0.85 [95% confidence interval (CI): 0.81-0.89]. The external validation resulted in an area under the curve of 0.76 (95% CI: 0.67-0.86) for the stage I model and 0.78 (95% CI: 0.69-0.86) for the stage I...