Artificial Intelligence-Based Delirium Prediction Model for Post-Cardiac Surgery Patients: A Scoping Review

Delirium is a common complication following cardiac surgery and significantly affects patient prognosis and quality of life. Recently, the application of artificial intelligence (AI) has gained prominence in predicting and assessing the risk of postoperative delirium, showing considerable potential in clinical settings.

This scoping review summarises existing research on AI-based prediction models for post-cardiac surgery delirium and provides insights and recommendations for clinical practice and future research.

Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, eight databases were searched: China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, Virtual Information Platform, PubMed, Web of Science, Medline, and Embase. Studies meeting the inclusion criteria were screened, and data were extracted on surgery type, delirium assessment tools, predictive factors, and AI-based prediction models. The search covered database inception through January 12, 2025. Two researchers independently conducted the literature review and data analysis.

Ten studies from China, Canada, and Germany involving 11,702 participants were included. The reported incidence of postoperative delirium ranged from 5.56% to 34%. The most commonly used assessment tools were Confusion Assessment Method for the Intensive Care Unit, Diagnostic and Statistical Manual of Mental Disorders-5, and Intensive Care Delirium Screening Checklist. Key predictive factors included age, cardiopulmonary bypass time, cerebrovascular disease, and pain scores. AI-based prediction models were primarily developed using R (6/10, 60%) and Python (4/10, 40%). Model performance, as measured by the area under the curve, ranged from 0.544 to 0.92. Among these models, Random Forest (RF) was the most effective (5/10, 50%), followed by XGBoost (3/10, 30%) and Artificial Neural Networks (2/10, 20%).

AI-based models show promise for predicting postoperative delirium in cardiac surgery patients. Future studies should prioritise integrating these models into clinical workflows, conducting rigorous multicenter external validation, and incorporating dynamic, time-varying perioperative variables to enhance generalizability and clinical utility.

This review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines.

This study did not include patient or public involvement in its design, conduct, or reporting.