Abstract
Purpose
To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing
ablative and reconstruction surgery for head and neck cancer.
Methods
Total 341 patients were retrospectively analyzed, and clinical variables in preoperative,
intraoperative and postoperative periods were compared between delirium group (n = 89)
and non-delirium group (n = 252). Multivariate logistic regression, receiver operating
characteristics curve, and area under the curve (AUC) were used to generate and test
a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure.
Results
In univariate and multivariate analysis, age, history of psychiatric disorder, marital
status, preoperative numeric rating scale for pain, ASA classification, and ICU stay
period were identified as significant risk factors. Using these factors, nomogram
for predicting the POD was developed and it showed sensitivity of 61.8%, specificity
of 75.4%, PPV of 47.0%, and NPV of 84.8% (Youden's index of 0.372). In 10-fold cross
validation set, corresponding values were 44.9%, 84.1%, 50.0% and 81.2% (Youden's
index of 0.337). AUC was comparable between two sets (0.7407 and 0.6898).
Conclusions
Proposed nomogram showed fair discriminative power for POD risk in head and neck cancer
patients undergoing major surgery.
Keywords
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Article info
Publication history
Published online: October 13, 2016
Accepted:
September 29,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
