Volume 22 Issue 9
Sep.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(9): 1596-1600
YANG Jing, LIU Mei, YANG Lei, GU Zejuan. Risk factors and predictive model construction of postoperative delirium in elderly patients with hip fracture[J]. Chinese Journal of General Practice, 2024, 22(9): 1596-1600. doi: 10.16766/j.cnki.issn.1674-4152.003691
Citation: YANG Jing, LIU Mei, YANG Lei, GU Zejuan. Risk factors and predictive model construction of postoperative delirium in elderly patients with hip fracture[J]. Chinese Journal of General Practice, 2024, 22(9): 1596-1600. doi: 10.16766/j.cnki.issn.1674-4152.003691
shu

Risk factors and predictive model construction of postoperative delirium in elderly patients with hip fracture

doi: 10.16766/j.cnki.issn.1674-4152.003691
  • 1.

    Orthopedics of the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China

Funds:

 CXTDA2017019

 BK20221415

  • Received Date: 2024-05-18
    Abstract
  •   Objective  The main treatment of hip fracture in the elderly is surgery, and postoperative delirium (POD) often occurs after surgery, increasing the risk of mortality. Therefore, this study mainly discusses the risk factors of POD and establishes a prediction model to take targeted interventions to reduce the occurrence of POD and improve the quality of life of patients.  Methods  The data of 137 patients with hip fractures admitted to the First Affiliated Hospital of Nanjing Medical University from June 2022 to December 2023 were selected. According to the diagnosis results of POD, the patients were divided into POD group (39 cases) and non-POD group (98 cases). The baseline data of the two groups were compared. Logistic regression was used to analyze the risk factors of POD in elderly patients with hip fracture and construct a nomogram model. The receiver operating characteristic (ROC) curve was drawn to test the predictive value of the nomogram model for POD.  Results  The age, preoperative waiting time, intraoperative blood loss and postoperative pain score of patients in the POD group were higher than those in the non-POD group, the preoperative albumin was lower than that in the non-POD group, and the proportion of patients with postoperative hypoxemia, diabetes and preoperative weakness was higher than that in the non-POD group (P<0.05). Logistic regression analysis showed that older age, long preoperative waiting time, postoperative hypoxemia, diabetes, preoperative weakness, and high postoperative pain score were risk factors for POD (OR>1, P<0.05). High preoperative albumin is a protective factor for POD (OR<1, P<0.05). The results showed that the C-index value was 0.972. The ROC results showed that the AUC was 0.986 (95% CI: 0.970-1.000, P<0.05), and the specificity, sensitivity, and Youden index were 0.959, 0.949, and 0.908, respectively.  Conclusion  Older age, long preoperative waiting time, postoperative hypoxemia, diabetes, preoperative frailty, high postoperative pain score and low preoperative albumin level are risk factors for POD in elderly patients with hip fracture. Based on this, a nomogram model is constructed to predict the occurrence of POD.

     

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