{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T19:08:35Z","timestamp":1793992115875,"version":"4.8.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Postoperative delirium, a common neurocognitive complication after surgery and anesthesia, requires early detection for potential intervention. Herein, we constructed a multidimensional postoperative delirium risk\u2010prediction model incorporating multiple demographic parameters and blood biomarkers to enhance prediction accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included 555 patients undergoing radical surgery for colorectal cancer. Demographic characteristics and lipid profiles were collected preoperatively, and perioperative anesthesia and surgical conditions were recorded; blood biomarkers were measured before and after surgery. The 3D\u2010CAM scale was used to assess postoperative delirium occurrence within 3\u2009days after surgery. Patients were divided into the postoperative delirium (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009100) and non\u2010postoperative delirium (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009455) groups. Based on machine learning, linear and nine non\u2010linear models were developed and compared to select the optimal model. Shapley value\u2010interpretation methods and mediation analysis were used to assess feature importance and interaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median age of the participants was 65\u2009years (interquartile range: 56\u201371\u2009years; 57.8% male). Among the 10 machine\u2010learning models, the random forest model performed the best (validation cohort, area under the receiver operating characteristic curve of 0.795 [0.704\u20130.885]). Lipid profile (total cholesterol, triglycerides, and trimethylamine\u2010N\u2010oxide) levels were identified as key postoperative delirium predictors. Mediation analysis further confirmed mediating effects among total cholesterol, trimethylamine\u2010N\u2010oxide, and postoperative delirium; a nomogram model was developed as a web\u2010based tool for external validation and use by other clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Blood biomarkers are crucial in predicting postoperative delirium and aid anesthesiologists in identifying its risks in a timely manner. This model facilitates personalized perioperative management and reduces the occurrence of postoperative delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ChiCTR2300075723<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70029","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:49:11Z","timestamp":1742197751000},"page":"976-985","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Development of a Disease Model for Predicting Postoperative Delirium Using Combined Blood Biomarkers"],"prefix":"10.1002","volume":"12","author":[{"given":"Hengjun","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaju","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"},{"name":"Operating Room The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Hejiang People's Hospital  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"},{"name":"Operating Room The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3259-7185","authenticated-orcid":false,"given":"Daiying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"},{"name":"Operating Room The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"},{"name":"Department of Anesthesiology Hejiang People's Hospital  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6162-0428","authenticated-orcid":false,"given":"Xiaoxia","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology The Affiliated Hospital, Southwest Medical University  Luzhou Sichuan China"},{"name":"Anesthesiology and Critical Care Medicine Key Laboratory of Luzhou Southwest Medical University  Luzhou Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.07.021"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.0111"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10062"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112923"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1605501"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.7260"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15613"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-020-00223-4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.12067"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106063"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.870317"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21212"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy799"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aba3683"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2024.111573"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathmechdis-051222-113147"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bib\/bbad236"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-018-1109-0"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.1018"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201006238\u20107"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/21514593211062277"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02762-w"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S398314"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13991"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2012.01472.x"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)00009-1"},{"key":"e_1_2_10_28_1","first-page":"110","article-title":"Cognitive Reserve and the Risk of Postoperative Cognitive Dysfunction","volume":"114","author":"Feinkohl I.","year":"2017","journal-title":"Deutsches \u00c4rzteblatt International"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.04.059"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109400"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2016.10.027"},{"key":"e_1_2_10_32_1","first-page":"2398","article-title":"Artificial Intelligence and Machine Learning in Clinical Medicine","volume":"388","author":"Shibue K.","year":"2023","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_10_33_1","doi-asserted-by":"crossref","unstructured":"A.Davoudi T.Ozrazgat\u2010Baslanti A.Ebadi et\u00a0al. \u201cDelirium Prediction Using Machine Learning Models on Predictive Electronic Health Records Data \u201d 2017 IEEE 17th International Conference on Bioinformatics and Bioengineering (BIBE). IEEE 2017.","DOI":"10.1109\/BIBE.2017.00014"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature14539"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14117"}],"container-title":["Annals of Clinical and Translational Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.70029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T08:11:40Z","timestamp":1747815100000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/acn3.70029"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/acn3.70029"],"URL":"https:\/\/doi.org\/10.1002\/acn3.70029","archive":["Portico"],"relation":{},"ISSN":["2328-9503","2328-9503"],"issn-type":[{"value":"2328-9503","type":"print"},{"value":"2328-9503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"2025-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}