Article Figures & Data
Figures
- Figure 1
Patient selection flow chart. A total of 664 cases met the inclusion criteria and 514 cases were included in the analysis after exclusion (59.9% in the development cohort and 40.1% in the validation cohort).
- Figure 2
Delirium predictive score receiver operating characteristic curve in the development and validation cohorts. The area under the curve (AUC) was 0.85 (95% CI 0.80 to 0.89) in the development cohort and 0.86 (95% CI 0.79 to 0.91) in the validation cohort.
- Figure 3
Calibration plot of the delirium predictive score in the development and validation cohorts. The horizontal axis shows the expected incidence and the vertical axis shows the actual measured incidence of delirium.
Tables
- Table 1
Clinical Frailty Score
Score Severity Definition 1 Very fit People who are robust, active, energetic, and motivated. These people commonly exercise regularly. They are among the fittest for their age. 2 Well People who have no active disease symptoms but are less fit than category 1. Often, they exercise or are very active occasionally, for example, seasonally. 3 Managing well People whose medical problems are well controlled, but are not regularly active beyond routine walking. 4 Vulnerable Although not dependent on others for daily help, often symptoms limit activities. A common complaint is being “sloped up” and/or being tired during the day. 5 Mildly frail These people often have more evident slowing and need help in high-order instrumental activities of daily living (finances, transportation, heavy housework, medications). Typically, mild frailty progressively impairs shopping and walking outside alone, meal preparation, and housework. 6 Moderately frail People need help with all outside activities and with keeping house. Inside, they often have problems with stairs and need help with bathing and might need minimal assistance (cuing, standby) with dressing. 7 Severely frail Completely dependent for personal care, from whatever cause (physical or cognitive). Even so, they seem stable and not at high risk of dying (within ~6 months). 8 Very severely frail Completely dependent, approaching the end of life. Typically, they could not recover from a minor illness. 9 Terminally ill Approaching the end of life. This category applies to people with a life expectancy <6 months, who are not otherwise evidently frail. - Table 2
Baseline characteristics and univariate analysis of the development and validation cohorts
Development cohort (n=308) Factor Delirium (n=91) No delirium (n=217) P value Age 77 (65–83) 58 (38–70) <0.0001 Sex, male (%) 54 (59.3) 158 (72.8) 0.0224 BMI 21.1 (17.9–23.5) 22.6 (20.2–25.1) <0.0001 Clinical Frailty Score 4 (3–4) 3 (2–3) <0.0001 Charlson index 0 (0–2) 0 (0–1) <0.0001 Smoking (%) 16 (17.6) 84 (38.7) 0.0003 Alcohol consumption (%) 35 (38.4) 117 (53.9) 0.0174 Dementia (%) 12 (13.2) 2 (0.922) <0.0001 Systolic blood pressure 137 (111–160) 141 (123–156) 0.1641 GCS score 14 (13–15) 15 (14–15) <0.0001 Heart rate 84 (71–100) 80 (70–92) 0.00393 BT (°C) 36.3 (36–36.8) 36.5 (36.1–36.9) 0.0212 Hemoglobin 121 (105–137) 137 (124–150) <0.0001 Fibrinogen 259 (226–335) 257 (210–305) 0.2482 FDP 60 (25.6–141) 16.7 (7–47.5) <0.0001 Lactate 2.3 (1.5–4) 2.1 (1.6–2.9) 0.1775 CRP 0.09 (0.03–0.4) 0.05 (0.02–0.14) 0.0012 RTS 7.84 (7.26–7.84) 7.84 (7.84–7.84) 0.0004 ISS 17 (10–26) 12 (9–19) 0.0002 TBI (%) 37 (57.8) 27 (42.2) <0.0001 Validation cohort (n=206) Factor Delirium (n=46) No delirium (n=160) P value Age 77 (63–85) 64 (42–75) <0.0001 Sex, male (%) 28 (60.9) 112 (70.0) 0.2827 BMI 21.1 (18.9–23.7) 22.6 (20.0–25.2) 0.0409 Clinical Frailty Score 4 (3–5) 3 (2–4) <0.0001 Charlson index 1 (0–1) 0 (0–1) 0.0220 Smoking (%) 12 (26.1) 55 (34.3) 0.3723 Alcohol consumption (%) 19 (41.3) 80 (50.0) 0.3195 Dementia (%) 12 (26.1) 5 (3.1) <0.0001 Systolic blood pressure 139 (113–160) 140 (120–164) 0.1247 GCS score 14 (13–15) 15 (14–15) <0.0001 Heart rate 82 (75–102) 79 (69–93) 0.0481 BT (°C) 36.4 (36–36.8) 36.6 (36.2–37) 0.0441 Hemoglobin 12.2 (10.3–13.9) 13.7 (12.2–15) <0.0001 Fibrinogen 276 (191–321) 259 (220–308) 0.8751 FDP 76.5 (22–120) 20.9 (6.2–47) <0.0001 Lactate 2.5 (1.7–3.4) 1.8 (1.4–2.7) 0.0081 CRP 0.08 (0.02–0.34) 0.04 (0.02–0.12) 0.0784 RTS 7.84 (7.55–7.84) 7.84 (7.84–7.84) <0.0001 ISS 17 (10–25) 14 (9–19) 0.0408 TBI (%) 16 (34.8) 35 (21.9) 0.0831 Values are mean (quarter value) or frequency (%).
BMI, body mass index; BT, body temperature; CRP, C-reactive protein; FDP, fibrin/fibrinogen degradation products; GCS, Glasgow Coma Scale; ISS, Injury Severity Score; RTS, Revised Trauma Score; TBI, traumatic brain injury.
