Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study
Abstract Background Prevention, screening, and early treatment are the aims of postoperative delirium management. The scoring system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery. Methods Patients who underwent cardiac surgery between...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02339-6 |
| _version_ | 1797784410153549824 |
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| author | Yu Tian Bingyang Ji Xiaolin Diao Chunrong Wang Weiwei Wang Yuchen Gao Sudena Wang Chun Zhou Qiaoni Zhang Sizhe Gao Xinyi Xu Jia Liu Jianhui Wang Yuefu Wang |
| author_facet | Yu Tian Bingyang Ji Xiaolin Diao Chunrong Wang Weiwei Wang Yuchen Gao Sudena Wang Chun Zhou Qiaoni Zhang Sizhe Gao Xinyi Xu Jia Liu Jianhui Wang Yuefu Wang |
| author_sort | Yu Tian |
| collection | DOAJ |
| description | Abstract Background Prevention, screening, and early treatment are the aims of postoperative delirium management. The scoring system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery. Methods Patients who underwent cardiac surgery between January 1, 2012, and January 1, 2019, were enrolled in our retrospective study. The patients were divided into a derivation cohort (n = 45,744) and a validation cohort (n = 11,436). The AD predictive systems were formulated using multivariate logistic regression analysis at three time points: preoperation, ICU admittance, and 24 h after ICU admittance. Results The prevalence of AD after cardiac surgery in the whole cohort was 3.6% (2,085/57,180). The dynamic scoring system included preoperative LVEF ≤ 45%, serum creatinine > 100 µmol/L, emergency surgery, coronary artery disease, hemorrhage volume > 600 mL, intraoperative platelet or plasma use, and postoperative LVEF ≤ 45%. The area under the receiver operating characteristic curve (AUC) values for AD prediction were 0.68 (preoperative), 0.74 (on the day of ICU admission), and 0.75 (postoperative). The Hosmer‒Lemeshow test indicated that the calibration of the preoperative prediction model was poor (P = 0.01), whereas that of the pre- and intraoperative prediction model (P = 0.49) and the pre, intra- and postoperative prediction model (P = 0.35) was good. Conclusions Using perioperative data, we developed a dynamic scoring system for predicting the risk of AD following cardiac surgery. The dynamic scoring system may improve the early recognition of and the interventions for AD. |
| first_indexed | 2024-03-13T00:39:30Z |
| format | Article |
| id | doaj.art-3c9117ae8d7540a49b5fe10d08969a0f |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-13T00:39:30Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-3c9117ae8d7540a49b5fe10d08969a0f2023-07-09T11:24:13ZengBMCJournal of Cardiothoracic Surgery1749-80902023-07-011811910.1186/s13019-023-02339-6Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational studyYu Tian0Bingyang Ji1Xiaolin Diao2Chunrong Wang3Weiwei Wang4Yuchen Gao5Sudena Wang6Chun Zhou7Qiaoni Zhang8Sizhe Gao9Xinyi Xu10Jia Liu11Jianhui Wang12Yuefu Wang13Department of Anesthesiology, Beijing AnZhen Hospital, Capital Medical UniversityDepartment of Cardiopulmonary Bypass, Fuwai Hospital,National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Information Center, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Information Center, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Anesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiopulmonary Bypass, Fuwai Hospital,National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiopulmonary Bypass, Fuwai Hospital,National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiopulmonary Bypass, Fuwai Hospital,National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Information Center, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Surgery Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical UniversityDepartment of Anesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Surgery Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical UniversityAbstract Background Prevention, screening, and early treatment are the aims of postoperative delirium management. The scoring system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery. Methods Patients who underwent cardiac surgery between January 1, 2012, and January 1, 2019, were enrolled in our retrospective study. The patients were divided into a derivation cohort (n = 45,744) and a validation cohort (n = 11,436). The AD predictive systems were formulated using multivariate logistic regression analysis at three time points: preoperation, ICU admittance, and 24 h after ICU admittance. Results The prevalence of AD after cardiac surgery in the whole cohort was 3.6% (2,085/57,180). The dynamic scoring system included preoperative LVEF ≤ 45%, serum creatinine > 100 µmol/L, emergency surgery, coronary artery disease, hemorrhage volume > 600 mL, intraoperative platelet or plasma use, and postoperative LVEF ≤ 45%. The area under the receiver operating characteristic curve (AUC) values for AD prediction were 0.68 (preoperative), 0.74 (on the day of ICU admission), and 0.75 (postoperative). The Hosmer‒Lemeshow test indicated that the calibration of the preoperative prediction model was poor (P = 0.01), whereas that of the pre- and intraoperative prediction model (P = 0.49) and the pre, intra- and postoperative prediction model (P = 0.35) was good. Conclusions Using perioperative data, we developed a dynamic scoring system for predicting the risk of AD following cardiac surgery. The dynamic scoring system may improve the early recognition of and the interventions for AD.https://doi.org/10.1186/s13019-023-02339-6Adult cardiac surgeryAgitated deliriumRisk prediction score systems |
| spellingShingle | Yu Tian Bingyang Ji Xiaolin Diao Chunrong Wang Weiwei Wang Yuchen Gao Sudena Wang Chun Zhou Qiaoni Zhang Sizhe Gao Xinyi Xu Jia Liu Jianhui Wang Yuefu Wang Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study Journal of Cardiothoracic Surgery Adult cardiac surgery Agitated delirium Risk prediction score systems |
| title | Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study |
| title_full | Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study |
| title_fullStr | Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study |
| title_full_unstemmed | Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study |
| title_short | Dynamic predictive scores for cardiac surgery-associated agitated delirium: a single-center retrospective observational study |
| title_sort | dynamic predictive scores for cardiac surgery associated agitated delirium a single center retrospective observational study |
| topic | Adult cardiac surgery Agitated delirium Risk prediction score systems |
| url | https://doi.org/10.1186/s13019-023-02339-6 |
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