| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | A Predictive Scoring Model for Perioperative Psychiatric Symptom Exacerbation in Schizophrenia Spectrum Disorders: Development and Internal Validation |
| 掲載誌名 | 正式名：Journal of the Academy of Consultation-Liaison Psychiatry 略 称：J Acad Consult Liaison Psychiatry ISSNコード：26672960/26672960 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Yoshihiro Matsumoto, Nobutaka Ayani, Masaki Fujiwara, Toshiya Funatsuki, Takashi Fukao, Shinji Ueda, Ai Takahashi, Nozomu Oya, Riki Kitaoka, Shinichiro Inoue, Jin Narumoto |
| 発行年月 | 2026/07 |
| 概要 | BACKGROUND:Patients with schizophrenia spectrum disorders (SSD) are vulnerable to clinically significant perioperative psychiatric deterioration, including delirium, which may require consultation-liaison psychiatry management and complicate medical and surgical care in general hospitals. Although postoperative delirium and non-delirious psychiatric worsening have been studied separately, no validated prediction tool has integrated these clinically relevant outcomes for perioperative risk assessment in patients with SSD.METHODS:We conducted a retrospective multicenter registry study of patients with SSD admitted to non-psychiatric wards for surgical treatment at three general acute care hospitals in Japan between April 2017 and March 2022. Perioperative psychiatric symptom exacerbation was defined as clinically meaningful deterioration requiring specialist psychiatric management, operationalized as psychiatrist-initiated psychotropic medication changes lasting ≥4 days, psychiatric symptom-related physical restraints, or transfer to a psychiatric ward. Predictors retained in the final model were identified using multivariable logistic regression, and a simplified scoring system was internally validated using bootstrap resampling.RESULTS:Among 200 patients, perioperative psychiatric symptom exacerbation occurred in 25 (12.5%). Emergency surgery, operative time ≥180 minutes, and admission from another hospital or facility were retained in the final multivariable model. The simplified score (0-3) showed acceptable discrimination (optimism-adjusted AUC 0.741). At a cut-off score ≥1, the model demonstrated high sensitivity (88.0%) and negative predictive value (95.5%), suggesting potential utility as a rule-out tool.CONCLUSIONS:This preliminary scoring model showed high sensitivity and negative predictive value in internal validation and may provide a framework for future validation as a perioperative triage-support tool. External validation is required before routine clinical implementation. |
| DOI | 10.1016/j.jaclp.2026.07.006 |
| PMID | 42468743 |