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Related Experiment Video

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Development and validation of a predictive model for postoperative delirium after traumatic cervical spinal cord

Han Xia1, Dilinuer Tusongtuoheti1

  • 1Xinjiang 474 Hospital, Urumqi, China.

Frontiers in Medicine
|December 22, 2025
PubMed
Summary

A new nomogram predicts postoperative delirium (POD) risk in traumatic cervical spinal cord injury (TCSCI) patients. This tool uses six clinical factors for early identification of high-risk individuals, aiding clinical decision-making.

Keywords:
internal validationnomogrampostoperative deliriumrisk predictiontraumatic cervical spinal cord injury

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Postoperative delirium (POD) is a significant complication following surgery for traumatic cervical spinal cord injury (TCSCI).
  • Accurate prediction of POD risk is crucial for timely intervention and improved patient outcomes.
  • Existing predictive models may not fully capture the specific risks associated with TCSCI surgery.

Purpose of the Study:

  • To develop and validate a nomogram for predicting the risk of POD in patients undergoing surgery for TCSCI.
  • To identify independent clinical factors associated with POD development in this patient population.
  • To provide a practical tool for clinicians to stratify POD risk.

Main Methods:

  • Retrospective analysis of 412 patients who underwent TCSCI surgery.
  • POD diagnosis using the Confusion Assessment Method (CAM).
  • Logistic regression to identify risk factors; nomogram construction and validation using AUC, calibration curves, and decision curve analysis (DCA).

Main Results:

  • The incidence of POD was 22.08%.
  • Six independent predictors were identified: diabetes mellitus, alcohol abuse history, ASIA Impairment Scale grade A-B, prolonged operative duration, intraoperative blood transfusion, and decreased postoperative hemoglobin.
  • The nomogram showed excellent discrimination (AUC 0.912) and high predictive accuracy.

Conclusions:

  • A validated nomogram incorporating six clinical factors can predict POD risk in TCSCI patients.
  • The nomogram demonstrates promising performance for early identification of high-risk individuals.
  • External validation is recommended prior to widespread clinical implementation.