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Area of Science:

  • Anesthesiology and Perioperative Medicine
  • Geriatric Medicine
  • Critical Care Medicine

Background:

  • Postoperative delirium (POD) is a common complication in surgical patients, associated with increased morbidity and mortality.
  • Accurate identification of patients at high risk for POD is crucial for implementing preventive strategies.

Purpose of the Study:

  • To identify independent risk factors associated with POD.
  • To develop and validate a predictive tool (nomogram) for POD risk assessment in surgical patients.

Main Methods:

  • Retrospective review of electronic health records (EHR) for 32,734 adult patients undergoing surgery with POD assessment.
  • Univariate and multivariable logistic regression analyses were performed to identify risk factors.
  • A nomogram was constructed to predict the risk of POD.

Main Results:

  • The overall incidence of POD was 3.7%.
  • Significant risk factors included older age, higher American Society of Anesthesiologists (ASA) score, depression, postoperative benzodiazepine use, and urgent/emergent surgical case status.
  • The predictive model achieved an AUC of 0.83.

Conclusions:

  • Individual risk factors contributing to POD were identified.
  • A clinically useful, easy-to-use nomogram was developed to accurately identify patients at high risk for POD, facilitating targeted prevention efforts.