A novel nomogram incorporating time-to-event modeling for predicting postoperative delirium in cardiac surgery patients.

IF 3.7 2区 医学 Q1 PSYCHIATRY
General hospital psychiatry Pub Date : 2025-09-01 Epub Date: 2025-08-06 DOI:10.1016/j.genhosppsych.2025.08.005
Zhengqin Liu, Lihua Zhu, Xiaohe Li, Qian Zhai
{"title":"A novel nomogram incorporating time-to-event modeling for predicting postoperative delirium in cardiac surgery patients.","authors":"Zhengqin Liu, Lihua Zhu, Xiaohe Li, Qian Zhai","doi":"10.1016/j.genhosppsych.2025.08.005","DOIUrl":null,"url":null,"abstract":"<p><p>Objective To develop and validate a predictive model of postoperative delirium (POD) for patients undergoing cardiac surgery. Methods 935 patients, admitted to the cardiovascular surgery intensive care unit between 2023.3.1 and 2023.12.31, were enrolled into this study. They were divided into the training set and the internal validation set at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) cox regression analysis was used to detect potential risk factors for POD and multivariable cox regression analysis was then conducted to construct the final nomogram model in the training set. Finally, we assessed the nomogram performance in terms of discrimination and calibration, including area under the curve (AUC), calibration curve and decision curve analysis (DCA) both in the training set and the internal validation set. Results 108 (16.34 %)patients in the training group and 47 (16.51 %) patients in the validation group developed POD respectively. Four independent risk factors were integrated into the nomogram including postoperative AKI, hypoalbuminemia, PSQI and CPOT score. The nomogram showed a good discrimination efficacy with an AUC of 0.882 (95 % CI: 0.843-0.922) and 0.921 (95 % CI: 0.871-0.972) in the training and internal validation set respectively. Both calibration curve and DCA demonstrated that this nomogram was clinically useful. Conclusions The nomogram based on four clinically available factors has good ability to identify POD risk in patients undergoing cardiovascular surgery. This tool may help physicians to prevent the appearance of delirium in advance using various methods and improve prognosis. ABBREVIATIONS.</p>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"96 ","pages":"253-263"},"PeriodicalIF":3.7000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"General hospital psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.genhosppsych.2025.08.005","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/6 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective To develop and validate a predictive model of postoperative delirium (POD) for patients undergoing cardiac surgery. Methods 935 patients, admitted to the cardiovascular surgery intensive care unit between 2023.3.1 and 2023.12.31, were enrolled into this study. They were divided into the training set and the internal validation set at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) cox regression analysis was used to detect potential risk factors for POD and multivariable cox regression analysis was then conducted to construct the final nomogram model in the training set. Finally, we assessed the nomogram performance in terms of discrimination and calibration, including area under the curve (AUC), calibration curve and decision curve analysis (DCA) both in the training set and the internal validation set. Results 108 (16.34 %)patients in the training group and 47 (16.51 %) patients in the validation group developed POD respectively. Four independent risk factors were integrated into the nomogram including postoperative AKI, hypoalbuminemia, PSQI and CPOT score. The nomogram showed a good discrimination efficacy with an AUC of 0.882 (95 % CI: 0.843-0.922) and 0.921 (95 % CI: 0.871-0.972) in the training and internal validation set respectively. Both calibration curve and DCA demonstrated that this nomogram was clinically useful. Conclusions The nomogram based on four clinically available factors has good ability to identify POD risk in patients undergoing cardiovascular surgery. This tool may help physicians to prevent the appearance of delirium in advance using various methods and improve prognosis. ABBREVIATIONS.

结合时间-事件模型的新型nomogram预测心脏手术患者术后谵妄。
目的建立并验证心脏手术患者术后谵妄(POD)的预测模型。方法选取2023.3.1 ~ 2023.12.31年心血管外科重症监护病房收治的935例患者作为研究对象。将它们按7:3的比例划分为训练集和内部验证集。使用最小绝对收缩和选择算子(LASSO) cox回归分析检测POD的潜在危险因素,然后进行多变量cox回归分析,构建训练集中最终的nomogram模型。最后,我们评估了nomogram在识别和校准方面的表现,包括在训练集和内部验证集中的曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)。结果训练组和验证组分别有108例(16.34%)和47例(16.51%)患者出现POD。将术后AKI、低白蛋白血症、PSQI和CPOT评分等4个独立危险因素纳入nomogram。模态图在训练集和内部验证集上的AUC分别为0.882 (95% CI: 0.843-0.922)和0.921 (95% CI: 0.871-0.972),显示出良好的鉴别效果。校正曲线和DCA均证明了该nomogram临床应用价值。结论基于临床可获得的4个因素的nomogram诊断心血管手术患者POD风险的能力较好。这个工具可以帮助医生使用各种方法提前预防谵妄的出现,改善预后。缩写词。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
General hospital psychiatry
General hospital psychiatry 医学-精神病学
CiteScore
9.60
自引率
2.90%
发文量
125
审稿时长
20 days
期刊介绍: General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信