Developing a nomogram for postoperative delirium in elderly patients with hip fractures  

作　　者：Liang Li Wei-Wei Sheng Li-Juan Song Shuai Cheng En-Gang Cui Yong-Bing Zhang Xue-Zhong Yu Yan-Li Liu 

机构地区：[1]Department of Orthopaedics and Traumatology,Dongying People’s Hospital,Dongying 257091,Shandong Province,China [2]Department of Health Care,Dongying People’s Hospital,Dongying 257091,Shandong Province,China [3]Department of Medical Imaging,Dongying People’s Hospital,Dongying 257091,Shandong Province,China [4]Department of Joint Surgery,Dongying People’s Hospital,Dongying 257091,Shandong Province,China [5]Department of Spine Surgery,Dongying People’s Hospital,Dongying 257091,Shandong Province,China

出　　处：《World Journal of Psychiatry》2025年第3期142-155,共14页世界精神病学杂志(英文)

基　　金：Supported by Wang Zhengguo Foundation for Traumatic Medicine“Sequential Medical Research Special Foundation”,No 2024-XGM05.

摘　　要：BACKGROUND Postoperative delirium(POD)is a prevalent complication,particularly in elderly patients with hip fractures(HFs).It significantly affects recovery,length of hospital stay,healthcare costs,and long-term outcomes.Existing studies have investigated risk factors for POD,but most are limited by single-factor analyses or small sample sizes.This study systematically determines independent risk factors using large-scale data and machine learning techniques and develops a validated nomogram model to support early prediction and management of POD.AIM To investigate POD incidence in elderly patients with HF and the independent risk factors,according to which a nomogram prediction model was developed and validated.METHODS This retrospective study included elderly patients with HF who were surgically treated in Dongying People’sHospital from April 2018 to April 2022. The endpoint event includes POD. They were categorized into themodeling and validation cohorts in a 7:3 ratio by randomization. Both cohorts were further classified into thedelirium and normal (non-delirium) groups according to the presence or absence of the endpoint event. Theincidence of POD was calculated, and logistic multivariate analysis was conducted to determine the independentrisk factors. The calibration curve and the Hosmer-Lemeshow test as well as the net benefit threshold probabilityinterval by the decision curve were utilized to statistically validate the accuracy of the nomogram predictionmodel, developed according to each factor’s influence intensity.RESULTSThis study included 532 elderly patients with HF, with an overall POD incidence of 14.85%. The comparison ofbaseline data with perioperative indicators revealed statistical differences in age (P < 0.001), number of comorbidities(P = 0.042), American Society of Anesthesiologists grading (P = 0.004), preoperative red blood cell(RBC) count (P < 0.001), preoperative albumin (P < 0.001), preoperative hemoglobin (P < 0.001), preoperativeplatelet count (P < 0.001), intraoperative blood l

关 键 词：Hip fracture Postoperative delirium NOMOGRAM Risk factor Retrospective study 

分 类 号：R749.4[医药卫生—神经病学与精神病学]