ObjectiveTo analyze the risk factors that affect the occurrence of delirium in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD), establish a nomogram prediction model and evaluate it.
MethodsA retrospective analysis of the clinical data of 382 COPD mechanically ventilated patients from January 2018 to August 2019 was performed.The patients were divided into delirium group and non-delirium group according to the occurrence of delirium.The risk factors of delirium in COPD patients with mechanical ventilation were screened by single factor and multivariate logistic regression models.The risk factors were incorporated into R software to establish a nomogram prediction model, and the area under the ROC curve was used to evaluate the discrimination of the model and test the goodness of fit.
ResultsThe incidence of delirium in COPD mechanically ventilated patients was 29.58%(113/382).Multivariate logistic regression showed that APACHEⅡ score(OR=1.075, 95% CI: 1.008-1.146), use of sedatives(OR=2.013, 95% CI: 1.185-3.420), use of physical restraint(OR=2.673, 95% CI: 2.673-5.362), mechanical ventilation time(OR=1.134, 95% CI: 1.064-1.207), ICU stay(OR=1.154, 95% CI: 1.075-1.239) were the independent risk factors that affect the occurrence of delirium in COPD patients with mechanical ventilation(P < 0.05 to P < 0.01).A nomogram prediction model was established and evaluated based on the relevant risk factors affecting the occurrence of delirium.The area under the ROC curve was 0.859(95% CI: 0.813-0.904);the slope of the nomogram calibration curve was close to 1;the model fitted well(χ2=4.73, P>0.05).
ConclusionsThe nomogram prediction model based on the risk factors of delirium in COPD patients with mechanical ventilation has good discrimination and consistency, which can provide some guidance for the prevention of delirium in COPD patients with mechanical ventilation.
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