A novel scale predicting postoperative delirium (POD) in patients undergoing cerebrovascular surgery

The purpose of this study was to develop and test a scale for predicting POD in patients undergoing cerebrovascular surgery.

The predictive scale for POD was composed of 32 items reflecting the strongest risk factors as determined by a literature review. The NEECHAM Confusion Scale determined POD onset and severity.

Delirium developed in 38 (31.1%) of the 122 patients in our sample. Logistic regression revealed the following risk factors: dehydration, age, disturbance of consciousness, underlying illness, and anxiety or depression. The final scale was weighted by referring to odds ratios. The area under the curve was 0.844 (95% CI=0.766-0.921). The possible total score on this scale was 20 points. A cutoff score of 11 was set for risk of POD (patients scoring over 12 were considered at higher risk). The median score was 8 (range: 4-9) in the non-delirium group and 13 (range: 9-16) in the delirium group (U=499.0; df=120; p<0.001). Scale scores were moderately correlated with delirium duration (ρ=0.532; p<0.001).

The present scale is a promising a tool for predicting POD but needs to be studied further.