A novel predictive model for postoperative delirium using multiple geriatric screening factors.
J Surg Oncol
; 127(6): 1071-1078, 2023 May.
Article
en En
| MEDLINE
| ID: mdl-36695780
ABSTRACT
OBJECTIVES:
The purpose of this study was to develop a new composite score to accurately predict postoperative delirium (POD) after major urological cancer surgery.METHODS:
Our retrospective analysis included, in total, 449 consecutive patients who experienced major urological cancer surgery and a preoperative geriatric functional assessment at our institution (development cohort). Geriatric functional assessments included Geriatric 8, Instrumental Activities of Daily Living, and mini-cognitive assessment instrument (Mini-Cog). Multivariate analysis was used to identify factors related to POD and combined to create a predictive score. The composite score was externally validated using a cohort of 92 consecutive pancreatic cancer patients who underwent pancreaticoduodenectomy and a preoperative geriatric functional assessment (validation cohort). The predictive accuracy and performance of the composite score were evaluated using the area under the receiver operating characteristic curves (AUC) and calibration plots.RESULTS:
In multivariate analysis of a development cohort, the following factors were significantly associated with POD a Mini-Cog score of <3 (odds ratio [OR] = 9.5; p < 0.001), disability in the responsibility for medication (OR = 4.1; p = 0.03), and the preoperative use of benzodiazepine (OR = 6.4; p < 0.001). The composite score of these three factors showed excellent discrimination in predicting POD, with AUC values of 0.819 and 0.804 in development and validation cohorts, respectively. Calibration plots showing predicted probability and actual observation in both cohorts showed good agreement.CONCLUSIONS:
A combined model of Mini-Cog, a disability in the responsibility for medication, and preoperative benzodiazepine use showed excellent discriminative power in predicting POD.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Delirio
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Delirio del Despertar
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Aged
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Humans
Idioma:
En
Revista:
J Surg Oncol
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón