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Development and validation of a postoperative delirium prediction model for patients admitted to an intensive care
Huanmin Xing1,2,3, Wendie Zhou4, Yuying Fan5
1Nursing Department, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Objectives:
We aimed to develop and validate a postoperative delirium (POD) prediction model for patients admitted to the intensive care unit (ICU).
Design:
A prospective study was conducted.
Setting:
The study was conducted in the surgical, cardiovascular surgical and trauma surgical ICUs of an affiliated hospital of a medical university in Heilongjiang Province, China.
Participants:
This study included 400 patients (≥18 years old) admitted to the ICU after surgery.
Primary And Secondary Outcome Measures:
The primary outcome measure was POD assessment during ICU stay.
Results:
The model was developed using 300 consecutive ICU patients and was validated using 100 patients from the same ICUs. The model was based on five risk factors: Physiological and Operative Severity Score for the enumeration of Mortality and morbidity; acid-base disturbance and history of coma, diabetes or hypertension. The model had an area under the receiver operating characteristics curve of 0.852 (95% CI 0.802 to 0.902), Youden index of 0.5789, sensitivity of 70.73% and specificity of 87.16%. The Hosmer-Lemeshow goodness of fit was 5.203 (p=0.736). At a cutoff value of 24.5%, the sensitivity and specificity were 71% and 69%, respectively.
Conclusions:
The model, which used readily available data, exhibited high predictive value regarding risk of ICU-POD at admission. Use of this model may facilitate better implementation of preventive treatments and nursing measures.
