Performance and agreement of risk stratification instruments for postoperative delirium in persons aged 50 years or older

Several risk stratification instruments for postoperative delirium in older people have been developed because early interventions may prevent delirium. We investigated the performance and agreement of nine commonly used risk stratification instruments in an independent validation cohort of consecutive elective and emergency surgical patients aged ≥50 years with ≥1 risk factor for postoperative delirium. Data was collected prospectively. Delirium was diagnosed according to DSM-IV-TR criteria. The observed incidence of postoperative delirium was calculated per risk score per risk stratification instrument. In addition, the risk stratification instruments were compared in terms of area under the receiver operating characteristic (ROC) curve (AUC), and positive and negative predictive value. Finally, the positive agreement between the risk stratification instruments was calculated. When data required for an exact implementation of the original risk stratification instruments was not availa...鉴于早期干预可预防术后谵妄，学界已针对老年患者术后谵妄开发出多款风险分层工具（risk stratification instruments）。本研究在一项独立验证队列中，对9款临床常用的术后谵妄风险分层工具的性能与一致性进行评估：该队列纳入连续收治的年龄≥50岁、且存在≥1项术后谵妄危险因素的择期与急诊手术患者。数据采集采用前瞻性设计。术后谵妄的诊断依据DSM-IV-TR标准。针对每一款风险分层工具，依据其风险评分计算术后谵妄的实际发生率。此外，本研究还以受试者工作特征（Receiver Operating Characteristic, ROC）曲线下面积（AUC）、阳性预测值与阴性预测值为指标，对各风险分层工具进行比较。最后，计算各风险分层工具间的阳性一致性。若某款风险分层工具的标准实施所需数据不全时...