• 1. Department of Intensive Care Unit, General Hospital of Eastern Theatre Command, The Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, 210002, P.R.China;
  • 2. Department of Professional Training of Clinical Nursing, General Hospital of Eastern Theatre Command, The Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, 210002, P.R.China;
ZHANG Aiqin, Email: aq09z@126.com
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Objectives To systematically review the delirium risk prediction models in intensive care unit (ICU) patients.Methods The Cochrane Library, PubMed, Web of Science, Ovid, VIP, WanFang Date and CNKI databases were electronically searched to collect studies on delirium risk prediction models in intensive care unit patients from inception to December, 2018. Two reviewers independently screened literature, extracted data, evaluated the included studies according to the CHARMS checklist, and then systematic review was performed to evaluate the risk prediction models.Results A total of 9 studies were included, of which 7 were prospective studies. Six models were internally validated. All studies reported the area under receiver operating characteristic curve (AUROC) over 0.7 (0.739-0.926). The reduction of cognitive reserve and increased blood urea nitrogen were the most commonly reported predisposing and precipitating factors of delirium among all prediction models. Methodologically, the absence or unreported of the blind method, to a certain extent, partially increase the risk of bias.Conclusions Nine prediction models all have great power in early identifying and screening patients who are at high risk of developing ICU delirium. On the basis of judiciously selecting a practical prediction model for clinical practice or carrying out a large sample-size prospective cohort study to construct the localized prediction model, stratified prevention strategies should be formulated and implemented according to the risk stratification results to reduce the incidence of ICU delirium and accelerate the rational allocation of medical resources for delirium prevention.

Citation: CHEN Junshan, YU Jintian, ZHANG Aiqin. Delirium risk prediction models in intensive care unit patients: a systematic review. Chinese Journal of Evidence-Based Medicine, 2019, 19(9): 1093-1100. doi: 10.7507/1672-2531.201901091 Copy

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