Journal of Clinical Medicine
Clinical Risk Factors and Inflammatory Markers as Predictors of Postoperative Delirium in Patients Undergoing Acute Type A Aortic Dissection Surgery
By Xiantong Cao, Botao Wang, 杨欢 and 6 others.
Abstract
Background
Postoperative delirium (POD) is a common and serious neurological complication following acute type A aortic dissection (ATAAD) repair, contributing to increased morbidity and mortality. Given the critical role of systemic inflammation in POD pathogenesis, this study aimed to evaluate perioperative inflammatory profiles in patients undergoing ATAAD repair and to develop a predictive nomogram for early POD risk stratification.
Methods
This retrospective, single-center study included 355 patients who underwent total arch replacement for ATAAD. Serial inflammatory markers were assessed across multiple perioperative time points. A two-stage variable selection process, incorporating variance inflation factor (VIF) and the Boruta algorithm, was utilized to identify robust predictors. A predictive nomogram was constructed via multivariable logistic regression. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). Internal validation was performed using 1000 bootstrap resamples.