VALIDATION OF A POSTOPERATIVE DELIRIUM PREDICTION MODEL

Abstract

Introduction A prediction model utilizing the National Surgical Quality Improvement Program risk calculator for serious complications (NSQIP-SC) and measures of cognitive function has been demonstrated to predict postoperative delirium incidence and severity in patients after non-cardiac surgery. The next step is to test this model's generalizability by validating in different patient populations and evaluating the robustness of the model with and without parameters of cognition. We hypothesized that the prediction model would still function in predicting postoperative delirium in patients undergoing major thoracic surgery. Methods A secondary data analysis of a randomized clinical trial involving 135 individuals who underwent major thoracic surgery from October 2013 to June 2015 was done. Delirium incidence and severity were tracked postoperatively through the Confusion Assessment Method for the ICU (CAM-ICU) and the Delirium Rating Scale-R-98 (DRS), respectively. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess preoperative cognition. Linear regressions and specificity/sensitivity calculations were performed to evaluate the model. Results One hundred and thirty-two patients with a mean age of 59±13?years, 33/132 CAM-ICU+, and a mean DRS peak of 3.12±3.43 were analyzed. Linear regression of NSQIP-SC scores moderately predicted delirium severity (P Conclusions NSQIP-SC was a predictor variable for delirium incidence and severity. Addition of a cognitive measure did not have any appreciable effect on the prediction model. Further expanding the scope of the model can grant clinicians a tool to identify patients at risk for developing postoperative delirium. This research was funded by: This project was funded, in part, with support from the Indiana Clinical and Translational Sciences Institute funded, in part by UL1TR002529 from the National Institutes of Health. The content is solely the responsibility of the authors and does not neces