Derivation and Validation of a Preoperative Prediction Rule for Delirium After Cardiac Surgery

• DOI: 10.1161/circulationaha.108.795260
• Publication Date: 2009-01-01T01:45:01Z
• Authors: James L. Rudolph; Richard N. Jones; Sue E. Levkoff; Christopher Rockett; Sharon K. Inouye; Frank W. Sellke; Shukri F. Khuri; Lewis A. Lipsitz; Basel Ramlawi; Sidney Levitsky; Edward R. Marcant...
• Keywords: Geriatric Depression Scale; Depression; Stroke

Delirium is a common outcome after cardiac surgery. prediction rules identify patients at risk for delirium who may benefit from targeted prevention strategies, early identification, and treatment of underlying causes. The purpose the present prospective study was to develop rule in surgery cohort validate it an independent cohort.Prospectively, > or =60 years age were enrolled derivation sample (n=122) then validation (n=109). Beginning on second postoperative day, underwent standardized daily assessment, diagnosed according confusion assessment method. occurred 63 (52%) patients. Multivariable analysis identified 4 variables independently associated with delirium: prior stroke transient ischemic attack, Mini Mental State Examination score, abnormal serum albumin, Geriatric Depression Scale. Points assigned each variable: < =23 received 2 points, score 24 27 1 point; Scale >4, stroke/transient albumin point each. In sample, cumulative incidence levels 0, 1, 2, =3 19%, 47%, 63%, 86%, respectively (C statistic, 0.74). corresponding 18%, 43%, 60%, 87%, 0.75).Delirium occurs frequently Using preoperative characteristics, clinicians can determine patients' delirium. Patients higher could be candidates close monitoring interventions prevent