Key result
CARDEL Index modestly predicts postoperative delirium after CABG with ~0.66 AUC.
Why the study?
Postoperative delirium is a serious complication of cardiac surgery, and this study aimed to evaluate the previously described CARDEL Index in a different patient database to assess its usefulness for predicting delirium after CABG.
Does the CARDEL Index accurately predict the occurrence of postoperative delirium in adult patients after CABG?
Cohort (n=1,098)
No
Does the CARDEL Index accurately predict the occurrence of postoperative delirium in adult patients after CABG?
The CARDEL Index, using routinely collected preoperative parameters, may be a useful and cost-effective tool to predict which patients are at elevated risk for delirium after CABG.
BACKGROUND: Postoperative delirium (POD) is a serious complication of cardiac surgery. It is an acute neuropsychiatric syndrome. The aim of this study was to analyze the CARDEL Index, composed of advancing age, preoperative glycated hemoglobin and the platelet-to-WBC ratio (PWR) previously described and calculated, using a different patient database, to assess its usefulness as a marker for predicting postoperative delirium after coronary artery by-pass grafting (CABG). METHODS: A retrospective analysis of 1098 patients who underwent, isolated CABG procedures between 2017 and 2019 was performed. RESULTS: Within the study group, 164/1098 (14.93%) patients were diagnosed with delirium. Preoperative inflammatory parameters were elevated in patients with delirium: White Blood Cell count (p=0.003), Neutrophil count (p=0.016) and C-reactive protein (p<0.001). A decrease in preoperative PWR was shown in patients with delirium (p=0.008). Delirious patients spent more time mechanically ventilated (p<0.001) and had longer hospitalization times (p=0.002). Mortality at 1 year was significantly higher in patients with POD (p<0.001). The CARDEL Index in this study group for POD detection has the largest area under the curve (AUC) of 0.664 (p<0.001) and a cut-off value of 8.08. CONCLUSION: CARDEL Index may be treated as a potentially valuable tool for delirium prediction in patients after CABG.
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Lechowicz et al. (2021) conducted a cohort in Postoperative delirium (POD) after CABG (n=1,098). CARDEL Index (advancing age, preoperative glycated hemoglobin, and platelet-to-WBC ratio) was evaluated on Detection of postoperative delirium (POD) (AUC 0.664, p=<0.001). The CARDEL Index predicted postoperative delirium after CABG with an area under the curve of 0.664 (p<0.001) at a cut-off value of 8.08.
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