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Thorac Cardiovasc Surg
DOI: 10.1055/a-2561-8604
Original Thoracic

Predicting the Risk of Postoperative Delirium in Patients Undergoing Lobectomy: Development and Assessment of a Novel Nomogram

Yanan Xue
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Ru Yu
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Wei Wang
2   Department of Thoracic Surgery, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Lei Li
3   Department of Neurology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Jing Tao
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Qin Zhuang
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Xiaohong Li
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
,
Yang Zhang
1   Department of Anesthesiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, People's Republic of China
› Institutsangaben
Funding This work was supported by the Key Natural Science Research Project of Anhui Province (grant number: 2023AH051993) and Key Natural Science Project of Bengbu Medical University (grant number: 2023byzd097).
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Abstract

Objective

To construct and internally validate a nomogram predicting postoperative delirium (POD) in patients with pulmonary malignancies undergoing lobectomy.

Methods

Clinical electronic medical record data were retrospectively collected from 1,066 patients who underwent lobectomy, divided into a training cohort (746) and a validation cohort (320) using a 7:3 temporal split. A nomogram for POD was developed using Lasso regression and multivariable logistic regression analysis according to the TRIPOD statement. Performance was assessed through receiver operating characteristic curves (ROC) and calibration plots.

Results

POD occurred in 203 patients (19.04%). The nomogram incorporated predictors such as age, body mass index (BMI), education level, history of diabetes, history of cerebrovascular disease, surgical approach, duration of surgery, and time to recovery from anesthesia. The area under the ROC curve (AUC) was 0.871 (95% confidence interval [CI]: 0.841–0.901) for the training cohort and 0.914 (95% CI: 0.877–0.951) for the validation cohort. Calibration curves demonstrated good agreement between predicted and actual probabilities in both cohorts.

Conclusion

This novel nomogram can help clinicians and patients' families predict the likelihood of developing delirium following lobectomy, enabling the implementation of targeted prevention strategies.

Keywords

delirium - postoperative - pneumonectomy - nomograms - risk factors - logistic models

Ethical Approval Statement

This study adhered to the principles outlined in the Declaration of Helsinki and obtained ethical approval from the Clinical Research Ethics Committee of the First Affiliated Hospital of Bengbu Medical University (approval number: 2023YJS210).


Authors' Contribution

Z.Y. designed the project. X.Y.N. and Y.R. were involved in data collection and analysis, manuscript drafting, and reviewing. W.W. provided expertise in surgical content and designed the manuscript. L.L. provided expertise in neuropsychology. T.J. and Z.Q. were responsible for manuscript preparation. L.X.H. provided expertise in anesthesiology, guided the data collection, performed the data analysis, and participated in drafting and reviewing the manuscript. All authors approved the final version of the manuscript.


Supplementary Material



Publikationsverlauf

Eingereicht: 18. Oktober 2024

Angenommen: 14. März 2025

Artikel online veröffentlicht:
18. April 2025

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