Predicting the Onset of Delirium on Hourly Basis in an Intensive Care Unit Following Cardiac Surgery

Abstract

Delirium, affecting up to 52% of cardiac surgery patients, can have serious long-term effects on patients by damaging cognitive ability and causing subsequent functional decline. This study reports on the development and evaluation of predictive models aimed at identifying the likely onset of delirium on an hourly basis in intensive care unit following cardiac surgery. Most models achieved a mean AUC > 0.900 across all lead times. A support vector machine achieved the highest performance across all lead times of AUC = 0.941 and Sensitivity = 0.907, and BARTm, where missing values were replaced with missForest imputation, achieved the highest Specificity of 0.892. Being able to predict delirium hours in advance gives clinicians the ability to intervene and optimize treatments for patients who are at risk and avert potentially serious and life-threatening consequences.