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. 2020 Jul:139:e127-e135.
doi: 10.1016/j.wneu.2020.03.160. Epub 2020 Apr 14.

Nomogram Model for Predicting Risk of Postoperative Delirium After Deep Brain Stimulation Surgery in Patients Older Than 50 Years with Parkinson Disease

Ling Zhan  1 , Xue-Qi Wang  1 , Li-Xiang Zhang  2
Affiliations

Nomogram Model for Predicting Risk of Postoperative Delirium After Deep Brain Stimulation Surgery in Patients Older Than 50 Years with Parkinson Disease

Ling Zhan et al. World Neurosurg. 2020 Jul.

Abstract

Objective: To explore the influencing factors of postoperative delirium (POD) after deep brain electric stimulation (DBS) in patients older than 50 years with Parkinson disease (PD) and to construct a nomogram model to predict the risk of POD.

Methods: A retrospective cohort study was conducted of 229 patients older than 50 years with PD hospitalized from January 2015 to August 2019. All patients received DBS during hospitalization. The incidence of POD of patients and clinical data such as gender, age, educational level, and duration of disease were collected, the influencing factors of POD of patients with PD were analyzed, and a nomogram model for predicting the risk of POD was established.

Results: POD occurred in 47 of 229 patients with PD, with an incidence rate of 20.52%. Gender, age, Parkinson's Disease Sleep Scale score, preoperative cerebral ischemia, preoperative pulmonary inflammation, and preoperative length of stay are the influencing factors of POD in patients older than 50 years with PD (P < 0.05). After deviation correction, the area under the receiver operating characteristic curve of the nomogram model for predicting POD risk is 0.755, the sensitivity is 74.47%, and the specificity is 73.08%. The mean absolute error between the prediction of POD risk by the nomogram model and actual delirium risk is 0.024, suggesting that the nomogram model has good prediction efficiency.

Conclusions: Based on the influencing factors of delirium after DBS for patients older than 50 years with PD, the nomogram model for predicting the risk of POD has been established in this study. The prediction efficiency is good, which can provide a reference for early clinical identification of high-risk patients and formulate interventional countermeasures as soon as possible.

Keywords: Advanced age; Deep brain stimulation; Nomogram; Parkinson disease; Postoperative delirium; Risk factor.

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