Construction of DynNom prediction model for postoperative delirium after off-pump coronary artery bypass grafting
Sun Yunliang
Si Linjie
Lu Zhen
Cheng Junyao
Guan Yuzhen
Abstract：Objective To construct a prediction model for postoperative delirium after off-pump coronary artery bypass grafting based on the DynNom dynamic score.Methods A total of 265 patients underwent off-pump coronary artery bypass grafting in Jiangsu Provincial People's Hospital from June 2020 to June 2023 were selected as study subjects.The clinical data of the patients were collected,and the patients were categorized into delirium group(n = 61)and non-delirium group(n = 204)according to the occurrence of postoperative delirium.Risk factors for postoperative delirium after off-pump coronary artery bypass grafting were analyzed by using univariate and multivariate Logistic regression analysis,and a DynNom prediction model was developed.Results The incidence of delirium after off-pump coronary artery bypass grafting was 23.02%(61/265).There was a statistically significant difference in glycosylated hemoglobin(HbA1c),mini-mental state examination(MMSE)score,nutritional risk screening(NRS)2002 score,left ventricular ejection fraction(LVEF),acid-base balance disorder,and electrolyte disorder between the two groups(P<0.05).Multivariate Logistic regression analysis showed that HbA1c≥7%,MMSE score<27,NRS2002 score≥3,LVEF<50%,acid-base balance disorder,and electrolyte disorder were independent risk factors for postoperative delirium after off-pump coronary artery bypass grafting(P<0.05).The validation results of the DynNom prediction model showed the C-index was 0.747(95%CI 0.711-0.783),the calibration curve was close to the ideal curve,the area under the receiver operating characteristic(ROC)curve(AUC)was 0.753(95%CI 0.721-0.785),and the net benefit of patients was>0 when the predictive value of the DynNom model was in the range of 10%to 79%.Conclusions The DynNom prediction model constructed based on the HbA1c≥7%,MMSE score<27,NRS2002 score≥3,LVEF<50%,acid-base balance disorder and electrolyte disorder has a certain predictive value in the risk of postoperative delirium after off-pump coronary artery bypass grafting.
Keywords：DynNom dynamic scoreOff-pump coronary artery bypass graftingPostoperative deliriumRisk factorsGlycosylated hemoglobinMini-mental state examinationNutritional risk screeningLeft ventricular ejection fraction
Publication Date：2024-05-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 391-396 )