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BMJ Publishing Group, BMJ Open, 11(9), p. e030733, 2019

DOI: 10.1136/bmjopen-2019-030733

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Development and validation of a postoperative delirium prediction model for patients admitted to an intensive care unit in China: a prospective study

Journal article published in 2019 by Huanmin Xing, Wendie Zhou, Yuying Fan ORCID, Taoxue Wen, Xiaohui Wang, Guangming Chang
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

ObjectivesWe aimed to develop and validate a postoperative delirium (POD) prediction model for patients admitted to the intensive care unit (ICU).DesignA prospective study was conducted.SettingThe study was conducted in the surgical, cardiovascular surgical and trauma surgical ICUs of an affiliated hospital of a medical university in Heilongjiang Province, China.ParticipantsThis study included 400 patients (≥18 years old) admitted to the ICU after surgery.Primary and secondary outcome measuresThe primary outcome measure was POD assessment during ICU stay.ResultsThe 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.ConclusionsThe 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.