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. 2023 Sep 15;23(1):184.
doi: 10.1186/s12911-023-02282-5.

A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III

Qiong Gu  1 , Shucong Yang  1 , DanTing Fei  1 , Yuting Lu  1 , Huijie Yu  2
Affiliations

A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III

Qiong Gu et al. BMC Med Inform Decis Mak. .

Abstract

Objective: To develop a nomogram for predicting the occurrence of sepsis-associated delirium (SAD).

Materials and methods: Data from a total of 642 patients were retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database to build a prediction model. Multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of SAD. The performance of the nomogram was assessed in terms of discrimination and calibration by bootstrapping with 1000 resamples.

Results: Multivariate logistic regression identified 4 independent predictors for patients with SAD, including Sepsis-related Organ Failure Assessment(SOFA) (p = 0.004; OR: 1.131; 95% CI 1.040 to 1.231), mechanical ventilation (P < 0.001; OR: 3.710; 95% CI 2.452 to 5.676), phosphate (P = 0.047; OR: 1.165; 95% CI 1.003 to 1.358), and lactate (P = 0.023; OR: 1.135; 95% CI 1.021 to 1.270) within 24 h of intensive care unit (ICU) admission. The area under the curve (AUC) of the predictive model was 0.742 in the training set and 0.713 in the validation set. The Hosmer - Lemeshow test showed that the model was a good fit (p = 0.471). The calibration curve of the predictive model was close to the ideal curve in both the training and validation sets. The DCA curve also showed that the predictive nomogram was clinically useful.

Conclusion: We constructed a nomogram for the personalized prediction of delirium in sepsis patients, which had satisfactory performance and clinical utility and thus could help clinicians identify patients with SAD in a timely manner, perform early intervention, and improve their neurological outcomes.

Keywords: Delirium; Nomogram; Sepsis; Sepsis-associated delirium.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the patient selection (MIMIC III, Medical Information Mart for Intensive Care III).
Fig. 2
Fig. 2
Nomogram for sepsis-associated delirium
Fig. 3
Fig. 3
ROC curves for the nomogram. Left: Training group; Right: Validation group
Fig. 4
Fig. 4
Calibration curve for predicting the probability of SAD. Left: Training group; Right: Validation group
Fig. 5
Fig. 5
Decision curve analysis in the prediction of SAD. Left: Training group; Right: Validation group
See this image and copyright information in PMC

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