Postoperative Delirium Cardiac Risk Score (Rudolph et al.) Calculator
- Geriatric Depression Scale – 5 item (GDS-5)
- History of Stroke or Transient Ischemic Attack
- Serum Albumin (g/dL) Abnormal is defined as <3.5 or >5.2 g/dL in the original rule.
- Postoperative Delirium Cardiac Risk Score (Rudolph et al., 2009): Explanation and Clinical Context
This pre-operative rule was derived and validated in older adults undergoing cardiac surgery and assigns points for cognitive impairment (MMSE), depressive symptoms (GDS-5), prior cerebrovascular disease (stroke/TIA), and abnormal serum albumin. Total points (0–5) stratify risk and can guide targeted prevention, enhanced monitoring, and early treatment. While the original cohort showed stepwise increases in delirium with each additional point, later studies reported variable discrimination across procedures and settings, so this score should complement—not replace—clinical judgment and local pathways (e.g., non-pharmacologic prevention bundles, early mobilization, sleep optimization, judicious sedation/analgesia).
Reference:
Rudolph JL, Jones RN, Levkoff SE, et al. Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation. 2009;119(2):229–236. doi:10.1161/CIRCULATIONAHA.108.795260.
Supporting summaries and subsequent evaluations: Liu C, et al. Nomogram for delirium after cardiovascular surgery, 2024 (context on contemporary models); Wueest AS, et al. 2023 external validation (performance varies by cohort).
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