Application of a Nomogram Model in Predicting Postoperative Delirium Following Percutaneous Coronary Intervention

应用列线图模型预测经皮冠状动脉介入治疗术后谵妄

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Abstract

Background: Postoperative delirium is associated with an increased number of different complications, such as prolonged hospital stay, long-term cognitive impairment, and increased mortality. Therefore, early prediction of delirium after percutaneous coronary intervention (PCI) is necessary, but currently, there is still a lack of reliable and effective prediction models for such patients. Methods: All data used in this study were derived from the MIMIC-IV database. Multivariable Cox regression was employed to analyze the data, and the performance of the newly developed nomogram was evaluated based on the area under the receiver operating characteristic curve (AUC). The clinical value of the prediction model was tested using decision curve analysis (DCA). Results: A total of 313 PCI patients in the intensive care unit (ICU) were included in the analysis, comprising 219 in the training cohort and 94 in the testing cohort. Twenty variables were selected for model development. Multivariable Cox regression revealed that benzodiazepine use, vasoactive drug therapy, age, white blood cell count (WBC), and serum potassium were independent risk factors for predicting the occurrence of delirium after PCI. The AUC values for predicting delirium occurrence in the training and validation cohorts were 0.771 and 0.743, respectively. Conclusions: This study has identified several important demographic and laboratory parameters associated with the occurrence of delirium after PCI, and used them to establish a more accurate and convenient nomogram model to predict the occurrence of postoperative delirium in such patients.

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