Influencing factors and risk prediction model for postoperative delirium in elderly orthopedic surgery patients
Objective To explore the independent risk factors for postoperative delirium(POD)in elderly orthopedic surgery patients and to construct a stepwise regression-based risk prediction model,in order to provide support for clinical treat-ment.Methods A total of 55 elderly orthopedic surgery patients with POD were selected as the delirium group(POD group),and 55 elderly orthopedic surgery patients without POD were selected as the non-delirium group.All patients were admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024.Clinical data,including demographic in-formation,comorbidities,American Society of Anesthesiologists(ASA)classification,preoperative cognitive dysfunction,preoperative malnutrition,lifestyle habits(smoking,drinking),surgical information,and laboratory results,were extracted from the hospital's electronic medical record system.Multivariate stepwise regression analysis was used to identify the inde-pendent risk factors for POD in elderly orthopedic surgery patients and to construct a risk prediction model.The model's predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results The multivariate step-wise regression analysis revealed that ASA classification Ⅲ(OR=17.581,95％CI:5.258-58.790),preoperative cogni-tive dysfunction(OR=15.743,95％CI:1.266-195.716),intraoperative hypoxemia(OR=16.040,95％CI:1.552-165.821),and preoperative albumin level＜35 g/L(OR=4.325,95％CI:1.527-12.250)were independent risk factors for POD in elderly orthopedic surgery patients(P＜0.05).The Hosmer-Lemeshow test showed good calibration for the constructed risk prediction model(x2=0.402,P=0.999).The ROC curve results indicated that the area under the curve(AUC)for predicting POD in elderly orthopedic surgery patients was 0.863(95％CI:0.794-0.932),with a sensitivity of 81.80％and a specificity of 78.20％.Conclusion ASA classification Ⅲ,preoperative cognitive dysfunction,intraoperative hypoxemia,and low preoperative albumin levels are independent risk factors for the occurrence of POD in elderly orthopedic surgery patients.The prediction model constructed based on these factors demonstrates good predictive efficacy for POD oc-currence.
Orthopedic surgeryElderlyPostoperative deliriumRisk model
万方数据
维普
