ICU脓毒症患者亚谵妄综合征风险预测模型的构建及验证

doi:10.3761/j.issn.2096-7446.2025.11.004

Abstract

Abstract:

Objective To analyze the risk factors of subsyndromal delirium（SSD） in Intensive Care Unit（ICU） patients with sepsis，construct and validate a risk prediction model for SSD，and provide an effective predictive tool for clinical practice. Methods The sepsis patients admitted to the intensive care unit（ICU） of a tertiary Grade A hospital in Xiamen，China were selected as research objects from April 2021 to October 2023. The delirium status of the patients was comprehensively evaluated using the Intensive Care Delirium Screening Checklist and the Confusion Assessment Method for the ICU，and the patients were divided into the SSD group and the non-delirium group. Univariate logistic regression analysis and LASSO regression were used for variable selection，and multivariate logistic regression analysis was conducted to establish a risk prediction model for SSD and construct static and dynamic nomograms. The predictive value of the model was comprehensively evaluated using calibration curves，receiver operating characteristic curves（ROC curves），and decision curve analysis（DCA）. Results The results of logistic regression analysis showed that age（OR=1.045），smoking history（OR=3.100），physical restraint（OR=3.611），remifentanil use（OR=0.040），and Richmond Agitation-Sedation Scale score（OR=0.244） were identified as independent risk factors for SSD in ICU patients with sepsis. The internal evaluation and validation results of the model showed that the areas under the ROC curves of the modeling group and the validation group were 0.877（95%CI：0.839~0.914） and 0.812（95%CI：0.718~0.906），respectively，indicating that the model had high predictive accuracy. The P values of the Hosmer-Lemeshow test were 0.548 and 0.623，respectively，indicating that the model fit well. Conclusion This study constructed a risk prediction model for SSD in ICU patients with sepsis，which is helpful for clinical medical staff to identify SSD early and take preventive measures，thereby reducing the risk of SSD in ICU patients with sepsis.

Key words: Intensive Care Unit, Sepsis, Subsyndromal Delirium, Risk Factors, Predictive Model, Nomogram

LIANG Yufeng, CHEN Qiaoling, FAN Zhenzhu, ZHU Xuanjing, HONG Xuepei, GONG Huafeng. Construction and validation of a predictive model for subsyndromal delirium in ICU patients with sepsis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(11): 1302-1309.

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Construction and validation of a predictive model for subsyndromal delirium in ICU patients with sepsis

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