210: LOW MEAN ARTERIAL PRESSURE IS NOT ASSOCIATED WITH POSTOPERATIVE DELIRIUM IN CARDIAC SURGERY PATIENTS
Bibliographic record
Abstract
Introduction: Delirium affects 26-52% of cardiac surgery patients, leading to extended mechanical ventilation, longer ICU stays, and increased mortality. Identifying adjustable risk factors such as blood pressure could enhance outcomes. Prior studies give mixed evidence about how perioperative hypotension impacts postoperative delirium. There’s also no universal definition for hypotension, complicating the issue. Therefore, comprehending the link between low MAP and postoperative delirium risk is essential. Methods: We carried out a retrospective review of adult patients undergoing cardiac surgery involving cardiopulmonary bypass from 2017 to 2020. Our aims were to examine the connection between intraoperative hypotension and postoperative delirium, and to pinpoint the Low MAP associated with a higher postoperative delirium rate. We included patients aged 18 or older having valve surgery, CABG, aortic procedures, or a combination, excluding those who had off-bypass CABG or procedures requiring hypothermic circulatory arrest. Data were collected from electronic medical records, with delirium defined via the ICU-CAM or bCAM, observed 12 to 96 hours post-surgery. We used multivariable logistic regression models, adjusted for demographics, co-morbidities, and procedure, to evaluate the relationship between low MAP and postoperative delirium. Low MAP’s added diagnostic value was measured using likelihood ratio tests. Results: Low MAP was approximately normally distributed (Figure 1). We found no confounder-adjusted association between Low MAP and post-operative delirium risk at any time period. These results are demonstrated by nearly flat spline curves (Figure 2), although MAP > 80mmhg was seen to have a significant positive correlation with delirium in unadjusted analysis. Likelihood ratio tests were not statistically significant (all P>0.05). Conclusions: These data provide no evidence that Low MAP increases risk for postoperative delirium in patients undergoing cardiac surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".