A study on the influencing factors of postoperative delirium in elderly patients with hip fractures treated with iliac fascia block
Objective To investigate the the influencing factors of postoperative delirium in el-derly patients with hip fractures treated with iliac fascia block and the diagnostic value of neutrophil/lympho-cyte ratio (NLR),insulin (INS),phosphorylated tau protein (p-tua).Methods The clinical data of 108 el-derly patients with hip fractures treated with iliac fascia block at Anqing First People's Hospital Affiliated to Anhui Medical University from January 2021 to September 2022 were extracted for retrospective analysis.The patients were divided into two groups:the postoperative delirium group (42 cases) and the postoperative non delirium group (66 cases) based on whether postoperative delirium occurred.Multivariate logistic regression was used to identify the risk factors for postoperative delirium in elderly patients with hip fractures after iliac fas-cial block.Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of com-bined detection of NLR,INS and p-tua in elderly patients with hip fractures after iliac fascial block.Results There were significant differences in age,preoperative carotid artery stenosis,operation time,levels of whole blood NLR,INS and p-tua between the postoperative delirium and postoperative non delirium groups (x2=8.911,13.487,t=8.623,6.030,6.952,6.398,5.946,P<0.05).Multivariate logistic regression analysis showed that age ≥ 60 years old,preoperative carotid artery stenosis,operation time ≥ 2.5 hours and higher lev-els of whole blood NLR,INS and p-tua were independent risk factors for postoperative delirium in elderly hip fracture patients with iliac fascia block (OR=2.489,4.125,2.040,3.438,2.942,2.962,P<0.05).ROC curve analysis showed that the area under the curve (AUC) values of whole blood NLR,INS,and p-tua for the diagnosis of postoperative delirium in elderly hip fracture patients with iliac fascial block were 0.905,higher than those of the levels of whole blood NLR,INS and p-tua alone (0.762,0.718,0.777,P<0.05).Conclusion Postoperative delirium in elderly hip fracture patients with iliac fascial block is related to being aged 60 years or older,preoperative carotid artery stenosis,operation time of 2.5 hours or longer,and high levels of whole blood NLR,INS,and p-tua.
Hip fractureOld ageIliac fascia blockPostoperative deliriumRisk factors
万方数据
维普
