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To explore the influencing factors of postoperative delirium (POD) after deep brain electric stimulation (DBS) in patients older than 50 years with Parkinson disease (PD) and to construct a nomogram model to predict the risk of POD. A retrospective cohort study was conducted of 229 patients older than 50 years with PD hospitalized from January 2015 to August 2019. All patients received DBS during hospitalization. The incidence of POD of patients and clinical data such as gender, age, educational level, and duration of disease were collected, the influencing factors of POD of patients with PD were analyzed, and a nomogram model for predicting the risk of POD was established. POD occurred in 47 of 229 patients with PD, with an incidence rate of 20.52%. Gender, age, Parkinson's Disease Sleep Scale score, preoperative cerebral ischemia, preoperative pulmonary inflammation, and preoperative length of stay are the influencing factors of POD in patients older than 50 years with PD (P < 0.05). After deviation correction, the area under the receiver operating characteristic curve of the nomogram model for predicting POD risk is 0.755, the sensitivity is 74.47%, and the specificity is 73.08%. The mean absolute error between the prediction of POD risk by the nomogram model and actual delirium risk is 0.024, suggesting that the nomogram model has good prediction efficiency. Based on the influencing factors of delirium after DBS for patients older than 50 years with PD, the nomogram model for predicting the risk of POD has been established in this study. The prediction efficiency is good, which can provide a reference for early clinical identification of high-risk patients and formulate interventional countermeasures as soon as possible. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to construct a nomogram for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). The present study retrospectively enrolled 165 patients with PD who had undergone DBS surgery. The patients were assessed using the Confusion Assessment Method for the Intensive Care Unit and were divided into 2 groups: the delirium group and nondelirium group. The nomogram for POD after DBS surgery was constructed from the results of univariate analysis and multivariate logistic analysis of the influencing factors for POD after DBS surgery. Univariate analysis revealed that the preoperative length of stay and the presence of preoperative brain atrophy, preoperative pulmonary inflammation, and postoperative cerebral edema were statistically significant. The results from the nonmotor symptoms scale for PD, mini-mental state examination, PD sleep scale, and unified PD rating scale III were also statistically significant (P < 0.05). Multivariate logistic regression analysis showed that the unified PD rating scale III (odds ratio [OR], 2.284; 95% confidence interval [CI], 1.614–3.232), nonmotor symptoms scale for PD (OR, 8.191; 95% CI, 5.629–11.917), PD sleep scale (OR, 0.058; 95% CI, 0.05–0.067), preoperative length of stay (OR, 1.230; 95% CI, 1.053–1.437), and preoperative brain atrophy (OR, 3.912; 95% CI, 3.5–4.255) were independent factors that influenced the occurrence of POD after DBS surgery. A nomogram model was constructed using these indicators. The model predicted an area under the receiver operating characteristic curve after DBS surgery of 0.870 (95% CI, 0.808–0.918), sensitivity of 74.19%, and specificity of 91.54%. The present study has presented a reliable and useful nomogram that can accurately predict the occurrence of POD after DBS surgery in patients with PD. This tool is easy to use and could assist physicians during the therapeutic decision-making process. [ABSTRACT FROM AUTHOR]