Retrospective evaluation of the PRE-DELIRIC score in a Chinese mixed ICU: implications for nursing practice

Delirium is a common complication in intensive care units (ICU). The PRE-DELIRIC model has shown promise in early delirium prediction, but its performance in Chinese ICU settings remains unclear. The objective of this study was to validate the PRE-DELIRIC model in a Chinese mixed medical-surgical ICU and evaluate its utility in guiding nursing interventions for delirium prevention. In this single-center retrospective cohort study, adult patients admitted to the ICU between January 2023 and October 2024 were included. The PRE-DELIRIC score was calculated within 24 h of admission. Delirium was assessed using Confusion Assessment Method for the ICU (CAM-ICU) every 8 h. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUROC). Among 580 patients, 176 (30.4%) developed delirium. The model showed good discrimination (AUROC 0.84; 95%CI: 0.81-0.87) and calibration (Hosmer-Lemeshow χ2=8.96, P=0.34). At the optimal cut-off point of 30%, sensitivity was 81.8% and specificity 78.2%, with 90.8% negative predictive value. Performance remained consistent across surgical (AUROC 0.84), medical (AUROC 0.86), and trauma patients (AUROC 0.85). Delirious patients had longer ICU stays (median 11.2 vs 7.1 days, P<0.001) and higher mortality (15.9 vs 10.4%, P=0.028). The PRE-DELIRIC model demonstrated reliable predictive performance in Chinese ICU settings. Integration into routine nursing assessment could guide individualized preventive interventions and optimize resource utilization.