Cai Xiaoyan, Yu Xuefen, Qin Jieying, Zhou Kebing, Li Zhiying, Zhang Jiahui, Zheng Dongxiang, Wang Peng, Yan Fengxia
Department of Nursing, Foshan Stomatology Hospital, the Affiliated Stomatology Hospital of Foshan University, Foshan, China.
School of Nursing, Jinan University, Guangzhou, China.
Psychogeriatrics. 2025 Mar;25(2):e13247. doi: 10.1111/psyg.13247.
To investigate the predictors of post-stroke delirium (PSD) in the old ischaemic stroke patients, and develop a nomogram to predict the risk of PSD.
A cross-observational study was conducted. The old ischaemic stroke patients in a tertiary hospital in South China were recruited and randomly divided into the train group and test group. Multivariate logistic regression analysis was performed in the train group to screen out predictors of PSD, and develop a nomogram. The receiver operating characteristic (ROC) curve, calibration curve, Hosmer-Lemeshow goodness-of-fit test (H-L test) and decision curve analysis (DCA) were used to evaluate the nomogram. The internal validation was performed in test group.
The incidence of PSD was 21.1% (105/497). Coronary heart disease (CHD), indwelling catheter, physical restraint, and neutrophil-to-lymphocyte ratio (NLR) were significantly associated with PSD. The area under the ROC curve of the nomogram was 0.885 in the train group, and 0.865 in the test group. The calibration curves of the two groups were close to the standardised line. The P-values of H-L test were over 0.05. The DCA presented some net benefits in the two groups.
CHD, indwelling catheter, restraint, and NLR were strongly associated with PSD in the old. A nomogram with good prediction effect and advisable clinical applicability was developed.
探讨老年缺血性脑卒中患者卒中后谵妄（PSD）的预测因素，并构建列线图以预测PSD风险。
进行一项交叉观察性研究。招募中国南方一家三级医院的老年缺血性脑卒中患者，并随机分为训练组和测试组。在训练组中进行多因素逻辑回归分析，以筛选出PSD的预测因素并构建列线图。采用受试者工作特征（ROC）曲线、校准曲线、Hosmer-Lemeshow拟合优度检验（H-L检验）和决策曲线分析（DCA）对列线图进行评估。在测试组中进行内部验证。
PSD发生率为21.1%（105/497）。冠心病（CHD）、留置导管、身体约束和中性粒细胞与淋巴细胞比值（NLR）与PSD显著相关。列线图在训练组的ROC曲线下面积为0.885，在测试组为0.865。两组的校准曲线均接近标准线。H-L检验的P值均大于0.05。DCA在两组中均显示出一定的净效益。
CHD、留置导管、约束和NLR与老年患者的PSD密切相关。构建了一个预测效果良好且具有临床适用性的列线图。
