Construction and validation of a predictive model for the risk of emergence delirium in older adult patients

doi:10.5498/wjp.v16.i6.115839

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jun 19, 2026; 16(6): 115839
Published online Jun 19, 2026. doi: 10.5498/wjp.v16.i6.115839

Table 1 General information about the patients in both the training and validation groups, n (%)/median (interquartile range

Variables	Training set (n = 705)				Validation set (n = 115)
Variables	Non-ED group (n = 584)	ED group (n = 121)	Z/χ² value	P value	Non-ED group (n = 96)	ED group (n = 19)	P value
Age	69.00 (65.00, 73.00)	74.00 (68.00, 78.00)	-5.850	< 0.001^a	67.50 (63.00, 73.25)	73.00 (69.50, 81.50)	0.002^a
BMI	24.00 (22.00, 26.00)	23.00 (21.00, 26.00)	-0.933	0.351	24.00 (22.00, 26.00)	24.00 (22.50, 26.50)	0.494
MMSE score	28.00 (26.75, 29.00)	24.00 (22.00, 26.00)	-12.518	< 0.001^a	28.00 (27.00, 30.00)	23.00 (22.50, 25.00)	< 0.001^a
Preoperative albumin level	41.75 (39.00, 44.00)	38.10 (34.80, 41.10)	-7.300	< 0.001^a	41.80 (39.75, 44.00)	38.00 (33.90, 40.60)	< 0.001^a
Surgical duration	75.00 (45.00, 125.00)	145.00 (95.00, 210.00)	-8.258	< 0.001^a	72.50 (45.00, 100.00)	120.00 (100.00, 142.50)	< 0.001^a
Intraoperative blood loss	10.00 (5.00, 30.00)	50.00 (20.00, 100.00)	-6.986	< 0.001^a	10.00 (5.00, 20.00)	50.00 (20.00, 50.00)	< 0.001^a
Intraoperative blood pressure variability	89.00 (50.00, 146.25)	122.00 (77.00, 167.00)	-3.726	< 0.001^a	81.00 (50.75, 150.00)	163.00 (127.00, 193.50)	0.001^a
Number of indwelling catheters	1.00 (0.00, 2.00)	2.00 (1.00, 3.00)	-8.542	< 0.001^a	1.00 (0.00, 2.00)	2.00 (1.00, 3.00)	< 0.001^a
Extubation time	20.00 (15.00, 30.00)	32.00 (25.00, 50.00)	-8.160	< 0.001^a	25.00 (16.00, 32.50)	40.00 (21.50, 50.00)	0.010^a
ASA classification	2.00 (2.00, 3.00)	3.00 (2.00, 3.00)	-5.373	< 0.001^a	2.00 (2.00, 3.00)	3.00 (2.00, 3.00)	0.023^a
Surgical risk score	0.00 (0.00, 1.00)	1.00 (0.00, 2.00)	-9.868	< 0.001^a	0.00 (0.00, 1.00)	1.00 (1.00, 2.00)	< 0.001^a
Sex			0.018	0.894			0.047^a
Female	305 (52.23)	64 (52.89)			37 (38.54)	12 (63.16)
Male	279 (47.77)	57 (47.11)			59 (61.46)	7 (36.84)
History of diabetes			5.269	0.022^a			0.774
No	478 (81.85)	88 (72.73)			75 (78.12)	16 (84.21)
Yes	106 (18.15)	33 (27.27)			21 (21.88)	3 (15.79)
History of stroke			10.111	0.001^a			0.718
No	550 (94.18)	104 (85.95)			91 (94.79)	17 (89.47)
Yes	34 (5.82)	17 (14.05)			5 (5.21)	2 (10.53)
Smoking history			0.943	0.331			1.000
No	564 (96.58)	114 (94.21)			92 (95.83)	18 (94.74)
Yes	20 (3.42)	7 (5.79)			4 (4.17)	1 (5.26)
Preoperative low hemoglobin level			33.192	< 0.001^a			0.003^a
No	525 (89.90)	85 (70.25)			88 (91.67)	12 (63.16)
Yes	59 (10.10)	36 (29.75)			8 (8.33)	7 (36.84)
Use of dexmedetomidine			0.670	0.413			0.054
No	148 (25.34)	35 (28.93)			18 (18.75)	8 (42.11)
Yes	436 (74.66)	86 (71.07)			78 (81.25)	11 (57.89)
Use of benzodiazepines			11.754	< 0.001^a			0.220
No	283 (48.46)	38 (31.40)			45 (46.88)	6 (31.58)
Yes	301 (51.54)	83 (68.60)			51 (53.12)	13 (68.42)
Use of anticholinergic agents			3.473	0.062			1.000
No	469 (80.31)	88 (72.73)			77 (80.21)	15 (78.95)
Yes	115 (19.69)	33 (27.27)			19 (19.79)	4 (21.05)
Nerve blocks			3.210	0.073			0.506
No	401 (68.66)	93 (76.86)			68 (70.83)	12 (63.16)
Yes	183 (31.34)	28 (23.14)			28 (29.17)	7 (36.84)
Type of surgery			41.656	< 0.001^a			0.119
General surgery	283 (48.46)	48 (39.67)			50 (52.08)	9 (47.37)
Orthopedic surgery	162 (27.74)	24 (19.83)			24 (25.00)	4 (21.05)
Urological surgery	52 (8.90)	26 (21.49)			9 (9.38)	3 (15.79)
Breast surgery	21 (3.60)	5 (4.13)			2 (2.08)	0 (0.00)
Gynecologic surgery	45 (7.71)	2 (1.65)			9 (9.38)	0 (0.00)
Thoracic surgery	21 (3.60)	16 (13.22)			2 (2.08)	3 (15.79)
PACU admission temperature			61.017	< 0.001^a			< 0.001^a
Afebrile	517 (88.53)	73 (60.33)			91 (94.79)	11 (57.89)
Hypothermia	58 (9.93)	45 (37.19)			3 (3.12)	7 (36.84)
Fever	9 (1.54)	3 (2.48)			2 (2.08)	1 (5.26)

^aP < 0.05.

BMI: Body mass index; MMSE: Mini-Mental State Examination; ASA: American Society of Anesthesiology; PACU: Post-anesthesia care unit.

Full Size Table

Table 2 Multivariate analysis of emergence delirium in postoperative older adult patients (n = 705)

Variables	β	SE	Z	P value	OR (95%CI)
Constant	17.229	2.248	7.665	< 0.001^a	-
MMSE score	-0.656	0.073	-9.039	< 0.001^a	0.519 (0.450-0.599)
Preoperative albumin level	-0.096	0.033	-2.898	0.004^a	0.908 (0.852-0.969)
Extubation time	0.006	0.002	2.379	0.017^a	1.006 (1.002-1.010)
Surgical risk score	0.466	0.214	2.177	0.029^a	1.594 (1.048-2.424)
Number of indwelling catheters	0.303	0.149	2.037	0.042^a	1.354 (1.011-1.813)
Extubation time	0.021	0.009	2.181	0.029^a	1.021 (1.003-1.039)

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; MMSE: Mini-Mental State Examination.

Full Size Table

Citation: Xin Y, He B, Wei XH, Yan YL, Huang C, Gao CY, Wang S, Zhang GM, Li R, Wu Y. Construction and validation of a predictive model for the risk of emergence delirium in older adult patients. World J Psychiatry 2026; 16(6): 115839
URL: https://www.wjgnet.com/2220-3206/full/v16/i6/115839.htm
DOI: https://dx.doi.org/10.5498/wjp.v16.i6.115839

Xin Y, He B, Wei XH, Yan YL, Huang C, Gao CY, Wang S, Zhang GM, Li R, Wu Y. Construction and validation of a predictive model for the risk of emergence delirium in older adult patients. World J Psychiatry 2026; 16(6): 115839 [DOI: 10.5498/wjp.v16.i6.115839]

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