Arun Oguzhan, Arun Funda
Department of Anesthesiology and Reanimation, Selcuk University Faculty of Medicine, Konya 42130, Türkiye.
Department of Pedodontics, Division of Anesthesiology, Selcuk University Faculty of Dentistry, Konya 42130, Türkiye.
World J Gastrointest Oncol. 2024 Sep 15;16(9):3765-3770. doi: 10.4251/wjgo.v16.i9.3765.
In this editorial, we comment on the article by Hu entitled "Predictive modeling for postoperative delirium in elderly patients with abdominal malignancies using synthetic minority oversampling technique" We wanted to draw attention to the general features of postoperative delirium (POD) as well as the areas where there are uncertainties and contradictions. POD can be defined as acute neurocognitive dysfunction that occurs in the first week after surgery. It is a severe postoperative complication, especially for elderly oncology patients. Although the underlying pathophysiological mechanism is not fully understood, various neuroinflammatory mechanisms and neurotransmitters are thought to be involved. Various assessment scales and diagnostic methods have been proposed for the early diagnosis of POD. As delirium is considered a preventable clinical entity in about half of the cases, various early prediction models developed with the support of machine learning have recently become a hot scientific topic. Unfortunately, a model with high sensitivity and specificity for the prediction of POD has not yet been reported. This situation reveals that all health personnel who provide health care services to elderly patients should approach patients with a high level of awareness in the perioperative period regarding POD.
在这篇社论中，我们对胡的题为“使用合成少数过采样技术对老年腹部恶性肿瘤患者术后谵妄进行预测建模”的文章发表评论。我们希望引起人们对术后谵妄（POD）的一般特征以及存在不确定性和矛盾的领域的关注。POD可定义为术后第一周出现的急性神经认知功能障碍。它是一种严重的术后并发症，尤其是对老年肿瘤患者而言。尽管其潜在的病理生理机制尚未完全了解，但人们认为各种神经炎症机制和神经递质都与之有关。已经提出了各种评估量表和诊断方法用于POD的早期诊断。由于谵妄在大约一半的病例中被认为是一种可预防的临床病症，最近在机器学习支持下开发的各种早期预测模型已成为一个热门的科学话题。不幸的是，尚未报道对POD预测具有高敏感性和特异性的模型。这种情况表明，所有为老年患者提供医疗服务的医护人员在围手术期应对POD患者保持高度警惕。
