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International Journal of Clinical Pharmacy

, Volume 38, Issue 4, pp 915–923 | Cite as

The development of an automated ward independent delirium risk prediction model

  • Hugo A. J. M. de WitEmail author
  • Bjorn Winkens
  • Carlota Mestres Gonzalvo
  • Kim P. G. M. Hurkens
  • Wubbo J. Mulder
  • Rob Janknegt
  • Frans R. Verhey
  • Paul-Hugo M. van der Kuy
  • Jos M. G. A. Schols
Research Article

Abstract

Background A delirium is common in hospital settings resulting in increased mortality and costs. Prevention of a delirium is clearly preferred over treatment. A delirium risk prediction model can be helpful to identify patients at risk of a delirium, allowing the start of preventive treatment. Current risk prediction models rely on manual calculation of the individual patient risk. Objective The aim of this study was to develop an automated ward independent delirium riskprediction model. To show that such a model can be constructed exclusively from electronically available risk factors and thereby implemented into a clinical decision support system (CDSS) to optimally support the physician to initiate preventive treatment. Setting A Dutch teaching hospital. Methods A retrospective cohort study in which patients, 60 years or older, were selected when admitted to the hospital, with no delirium diagnosis when presenting, or during the first day of admission. We used logistic regression analysis to develop a delirium predictive model out of the electronically available predictive variables. Main outcome measure A delirium risk prediction model. Results A delirium risk prediction model was developed using predictive variables that were significant in the univariable regression analyses. The area under the receiver operating characteristics curve of the “medication model” model was 0.76 after internal validation. Conclusions CDSSs can be used to automatically predict the risk of a delirium in individual hospitalised patients’ by exclusively using electronically available predictive variables. To increase the use and improve the quality of predictive models, clinical risk factors should be documented ready for automated use.

Keywords

Automation Decision support systems Decision support techniques Delirium Hospital Predicting 

Notes

Acknowledgments

We thank Eugene Hardy for aiding in the retrieval of the delirium diagnosis dates.

Funding

The SCREEN-study was supported by a grant from ZonMW, Grant Number 113101001.

Conflicts of interest

The authors declare no conflict of interest.

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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Hugo A. J. M. de Wit
    • 1
    Email author
  • Bjorn Winkens
    • 2
  • Carlota Mestres Gonzalvo
    • 3
  • Kim P. G. M. Hurkens
    • 4
  • Wubbo J. Mulder
    • 5
  • Rob Janknegt
    • 3
  • Frans R. Verhey
    • 6
  • Paul-Hugo M. van der Kuy
    • 3
  • Jos M. G. A. Schols
    • 7
  1. 1.Department of Clinical PharmacyZuyderland Medical CentreHeerlenThe Netherlands
  2. 2.Department of Methodology and Statistics, CAPHRI-School for Public Health and Primary CareMaastricht UniversityMaastrichtThe Netherlands
  3. 3.Department of Clinical PharmacyZuyderland Medical CentreSittard-GeleenThe Netherlands
  4. 4.Section of Geriatric Medicine, Department of Internal MedicineZuyderland Medical CentreHeerlenThe Netherlands
  5. 5.Department of Internal MedicineMaastricht University Medical CentreMaastrichtThe Netherlands
  6. 6.Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg/School for Mental Health and NeurosciencesMaastricht UniversityMaastrichtThe Netherlands
  7. 7.Department of General Practice and Department of Health Services Research, CAPHRI-School for Public Health and Primary CareMaastricht UniversityMaastrichtThe Netherlands

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