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The purpose of this study was to develop and evaluate a POD prediction model for patients undergoing abdominal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One thousand consecutive patients scheduled for elective abdominal surgery from July 2019 to March 2021 in Ruijin Hospital, Shanghai China, were retrospectively analysed, and their demographics, pre-operative evaluation, and intra-operative parameters were collected and cross-analysed. The primary outcome was the POD incidence. A prediction model of POD was established and internal validation was conducted with various analyses including univariate and multivariate regression. Data from another cohort of346 patients enrolled from July 2021 to December 2021 were used for model external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After screening, 838 patients were included as the training cohort and 10.9% (91\/838) of the patients manifested POD. Old age, cerebrovascular disease and diazepam use history and intraoperative fluid imbalance were the main contributors of the POD prediction model. The optimum cut-off point of the predicted probability that maximised the sum of sensitivity and specificity was 0.12. The fitting set AUC was 0.703 (95% Confidence interval (CI) 0.637\u20130.753). The sensitivity and specificity of the model were 0.556 and 0.754 respectively. The mean AUC during the cross and external validation of the model was 0.684 [Standard Deviation (SD) 0.068] and 0.634 (95%CI 0.511\u20130.758) respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data indicated that improving perioperative management may reduce POD incidence in patients who are old age and have cerebrovascular disease history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      The retrospective data (ChiCTR2100047405) of this study was registered in the Chinese Clinical Trial registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/\" ext-link-type=\"uri\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13741-025-00639-0","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T05:35:44Z","timestamp":1772256944000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a post-operative delirium prediction model for patients undergoing abdominal surgery: a retrospective, observational, single-center study"],"prefix":"10.1186","volume":"15","author":[{"given":"Zhi-Hua","family":"Huang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maneesh Kumarsing","family":"Beeharry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Ying","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Rong","family":"Bao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-3162","authenticated-orcid":false,"given":"Yan","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"issue":"1","key":"639_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1007\/s00192-022-05170-0","volume":"34","author":"MF Ackenbom","year":"2023","unstructured":"Ackenbom MF, Zyczynski HM, Butters MA, et al. 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Age Ageing. 2020;49(6):1020\u20137.","journal-title":"Age Ageing"}],"container-title":["Perioperative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13741-025-00639-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-025-00639-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13741-025-00639-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T09:02:46Z","timestamp":1774515766000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13741-025-00639-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["639"],"URL":"https:\/\/doi.org\/10.1186\/s13741-025-00639-0","relation":{},"ISSN":["2047-0525"],"issn-type":[{"value":"2047-0525","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]},"assertion":[{"value":"3 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This retrospective study was approved by the Ethics Committee of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine. A retrospective registration of the study has been submitted to the World Health Organization Clinical Trials - International Registry Platform (WHO-ICTRP) with Registration ID ChiCTR2100047405 (18\/06\/2021). Written informed consent from all patients involved in the study was exempted due to the retrospective nature of the study. This study complied with the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"24"}}