Factors related to post-operative delirium in middle-aged and elderly patients in intensive care unit and risk prediction model
10.3969/j.issn.1006-9771.2022.03.010
- VernacularTitle:重症监护室中老年患者术后谵妄影响因素分析及风险预测模型建立与评价
- Author:
Zhangwei GE
1
,
2
,
3
;
Xin HUANG
1
,
2
,
3
;
Zhengdong LIU
1
,
2
,
3
;
Min ZHANG
1
,
2
,
3
;
Jiakui ZHANG
4
,
5
Author Information
1. 1. Department of Critical Care Medicine, Lu'
2. an Hospital of Anhui Medical University, Lu'
3. an, Anhui 237005, China
4. 2. Department of Hematology, Hefei Second People'
5. s Hospital, Hefei, Anhui 230011, China
- Publication Type:Journal Article
- Keywords:
intensive care unit, postoperative, delirium, influencing factors, middle-aged and elderly
- From:
Chinese Journal of Rehabilitation Theory and Practice
2022;28(3):340-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of post-operative delirium (POD) in middle-aged and elderly patients in intensive care unit (ICU) and construct risk prediction model for it.Methods A total of 112 middle-aged and elderly postoperative patients in the ICU of Lu'an Hospital of Anhui Medical University from January, 2018 to February, 2021 were selected. On the second day after the operation, they were transferred to ICU, and assessed with the Confusion AssessmentMethod for Intensive Care Unit (CAM-ICU). The patients were divided into delirium group (n = 52) and non-delirium group (n = 60) according to assessment. Univariate analysis was used to compare the differences in clinical data between the two groups, and multivariate Logistic regression analysis was used to screen the independent influencing factors to construct risk prediction model. Receiver operating characteristic (ROC) curve was used to evaluate prediction performance. Results Multivariate logistic regression analysis showed Acute Physiology and Chronic Health Evaluation II score (APACHE II score) (OR = 1.424, 95%CI 1.204 to 1.685, P < 0.001), ICU sleep quality score (OR = 1.432, 95%CI 1.159 to 1.770, P < 0.001), and postoperative oxygenation index ≤ 300 (OR = 4.485, 95%CI 1.644 to 12.240, P = 0.001) were independent influencing factors of postoperative delirium in ICU. The prediction model was: logit(P) = -11.381+0.354X1 (APACHE II score, cut-off value 16)+0.359X2 (ICU sleep quality score, cut-off value 13)+1.501X3 (postoperative oxygenation index ≤ 300), with the sensitivity and specificity of 79.2% and 79.7% respectively. The area under the ROC curve was 0.866 (95%CI 0.801 to 0.930), more than those of the factors alone (P < 0.05). Conclusion The prediction model based on Logistic regression can predict the occurrence of postoperative delirium in middle-aged and elderly patients in ICU.
