Development and validation of a postoperative delirium prediction model for patients admitted to an intensive care unit in China: a prospective study

<p>Objectives: We aimed to develop <span class="il">and</span> validate <span class="il">a</span> <span class="il">postoperative</span> <span class="il">delirium</span> (POD) <span class="il">prediction</span> model for patients admitted to the intensive care unit (ICU).</p> <p>Design: <span class="il">A</span> prospective study was conducted.</p> <p>Setting: The study was conducted in the surgical, cardiovascular surgical, <span class="il">and</span> trauma surgical ICUs <span class="il">of</span> an affiliated hospital <span class="il">of</span> <span class="il">a</span> medical university in Heilongjiang Province, China.</p> <p>Participants: This study included 400 patients (≥18 years old) admitted to the ICU after surgery.</p> <p>Primary <span class="il">and</span> secondary outcome measures: The primary outcome measure was <span class="il">postoperative</span> <span class="il">delirium</span> assessment during ICU stay.</p> <p>Results: The model was developed using 300 consecutive ICU patients <span class="il">and</span> was validated using 100 patients from the same ICUs. The model was based on five risk factors: Physiological <span class="il">and</span> Operative Severity Score for the Enumeration <span class="il">of</span> Mortality <span class="il">and</span> Morbidity; acid-base disturbance; <span class="il">and</span> history <span class="il">of</span> coma, diabetes, or hypertension. The model had an area under the receiver operating characteristics curve <span class="il">of</span> 0.852 (95% confidence interval: 0.802–0.902), Youden index <span class="il">of</span> 0.5789, sensitivity <span class="il">of</span> 70.73%, <span class="il">and</span> specificity <span class="il">of</span> 87.16%. The Hosmer-Lemeshow goodness <span class="il">of</span> fit was 5.203 (P = 0.736). At <span class="il">a</span> cut-off <span class="il">of</span> 24.5%, the sensitivity <span class="il">and</span> specificity were 71% <span class="il">and</span> 69%, respectively.</p> <p>Conclusions: The model, which used readily available data, exhibited high predictive value regarding risk <span class="il">of</span> intensive care unit <span class="il">postoperative</span> <span class="il">delirium</span> (ICU-POD) at admission. Use <span class="il">of</span> this model may facilitate better implementation <span class="il">of</span> preventive treatments <span class="il">and</span> nursing measures.</p>