{"title":"预测心血管手术患者术后谵妄风险的提名图。","authors":"Chao Liu, Linfei Zhang, Weifeng Tang, Sheng Zhao, Mingke Li, Jinghang Li, Yongfeng Shao","doi":"10.1111/ene.16483","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Delirium is a common mental disorder after adult cardiovascular surgery. Fifteen to 23% of patients undergoing cardiovascular surgery and cardiomyopathy experience delirium, and the efficacy of treatment interventions for delirium has been consistently unsatisfactory.</p><p><strong>Methods: </strong>A total of 729 patients who underwent cardiovascular surgery were randomly allocated into a training set and a validation set. A nomogram was developed using a logistic regression model to predict the incidence of delirium following cardiovascular surgery. The validity of the model was assessed by determining the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUROC), performing a calibration plot, and executing a decision curve analysis. This model was internally validated using the bootstrap method.</p><p><strong>Results: </strong>Postoperative delirium (POD) occurred in 165 cases (22.6%) among the 729 patients. Predictors included age, transient ischemic attack, length of preoperative stay, preoperative left ventricular injection fraction and N-terminal pro-B-type natriuretic peptide level, and intraoperative infusion of dexmedetomidine and human fibrinogen. The nomogram showed sufficient differentiation and calibration (AUROC = 0.754, 95% confidence interval = 0.703-0.804). The calibration graphs showed that the predictive values of the nomogram were in agreement with the actual values. The analysis of the training and validation sets suggested that the model possessed specific clinical significance.</p><p><strong>Conclusions: </strong>In summary, the predictive model consists of seven factors that can roughly predict the occurrence of POD in patients who undergo cardiovascular surgery.</p>","PeriodicalId":11954,"journal":{"name":"European Journal of Neurology","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A nomogram for predicting the risk of postoperative delirium in individuals undergoing cardiovascular surgery.\",\"authors\":\"Chao Liu, Linfei Zhang, Weifeng Tang, Sheng Zhao, Mingke Li, Jinghang Li, Yongfeng Shao\",\"doi\":\"10.1111/ene.16483\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Delirium is a common mental disorder after adult cardiovascular surgery. Fifteen to 23% of patients undergoing cardiovascular surgery and cardiomyopathy experience delirium, and the efficacy of treatment interventions for delirium has been consistently unsatisfactory.</p><p><strong>Methods: </strong>A total of 729 patients who underwent cardiovascular surgery were randomly allocated into a training set and a validation set. A nomogram was developed using a logistic regression model to predict the incidence of delirium following cardiovascular surgery. The validity of the model was assessed by determining the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUROC), performing a calibration plot, and executing a decision curve analysis. This model was internally validated using the bootstrap method.</p><p><strong>Results: </strong>Postoperative delirium (POD) occurred in 165 cases (22.6%) among the 729 patients. Predictors included age, transient ischemic attack, length of preoperative stay, preoperative left ventricular injection fraction and N-terminal pro-B-type natriuretic peptide level, and intraoperative infusion of dexmedetomidine and human fibrinogen. The nomogram showed sufficient differentiation and calibration (AUROC = 0.754, 95% confidence interval = 0.703-0.804). The calibration graphs showed that the predictive values of the nomogram were in agreement with the actual values. The analysis of the training and validation sets suggested that the model possessed specific clinical significance.</p><p><strong>Conclusions: </strong>In summary, the predictive model consists of seven factors that can roughly predict the occurrence of POD in patients who undergo cardiovascular surgery.</p>\",\"PeriodicalId\":11954,\"journal\":{\"name\":\"European Journal of Neurology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-09-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ene.16483\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ene.16483","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
A nomogram for predicting the risk of postoperative delirium in individuals undergoing cardiovascular surgery.
Background and purpose: Delirium is a common mental disorder after adult cardiovascular surgery. Fifteen to 23% of patients undergoing cardiovascular surgery and cardiomyopathy experience delirium, and the efficacy of treatment interventions for delirium has been consistently unsatisfactory.
Methods: A total of 729 patients who underwent cardiovascular surgery were randomly allocated into a training set and a validation set. A nomogram was developed using a logistic regression model to predict the incidence of delirium following cardiovascular surgery. The validity of the model was assessed by determining the receiver operating characteristic (ROC) curve, calculating the area under the ROC curve (AUROC), performing a calibration plot, and executing a decision curve analysis. This model was internally validated using the bootstrap method.
Results: Postoperative delirium (POD) occurred in 165 cases (22.6%) among the 729 patients. Predictors included age, transient ischemic attack, length of preoperative stay, preoperative left ventricular injection fraction and N-terminal pro-B-type natriuretic peptide level, and intraoperative infusion of dexmedetomidine and human fibrinogen. The nomogram showed sufficient differentiation and calibration (AUROC = 0.754, 95% confidence interval = 0.703-0.804). The calibration graphs showed that the predictive values of the nomogram were in agreement with the actual values. The analysis of the training and validation sets suggested that the model possessed specific clinical significance.
Conclusions: In summary, the predictive model consists of seven factors that can roughly predict the occurrence of POD in patients who undergo cardiovascular surgery.
期刊介绍:
The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).