Predicting the Risk of Postoperative Delirium in Elderly Patients Undergoing Hip Arthroplasty: Development and Assessment of a Novel Nomogram.

IF 2.1 4区 医学 Q2 SURGERY
Journal of Investigative Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI:10.1080/08941939.2024.2381733
Yang Zhang, Li-Juan Xie, Ruo-Jie Wu, Cong-Li Zhang, Qin Zhuang, Wen-Tao Dai, Min-Xin Zhou, Xiao-Hong Li
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引用次数: 0

Abstract

Objective: To construct and internally validate a nomogram that predicts the likelihood of postoperative delirium in a cohort of elderly individuals undergoing hip arthroplasty.

Methods: Data for a total of 681 elderly patients underwent hip arthroplasty were retrospectively collected and divided into a model (n = 477) and a validation cohort (n = 204) according to the principle of 7:3 distribution temporally. The assessment of postoperative cognitive function was conducted through the utilization of The Confusion Assessment Method (CAM). The nomogram model for postoperative cognitive impairments was established by a combination of Lasso regression and logistic regression. The receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis (DCA) were used to evaluate the performance.

Results: The nomogram utilized various predictors, including age, body mass index (BMI), education, preoperative Barthel Index, preoperative hemoglobin level, history of diabetes, and history of cerebrovascular disease, to forecast the likelihood of postoperative delirium in patients. The area under the ROC curves (AUC) for the nomogram, incorporating the aforementioned predictors, was 0.836 (95% CI: 0.797-0.875) for the training set and 0.817 (95% CI: 0.755-0.880) for the validation set. The calibration curves for both sets indicated a good agreement between the nomogram's predictions and the actual probabilities.

Conclusion: The use of this novel nomogram can help clinicians predict the likelihood of delirium after hip arthroplasty in elderly patients and help prevent and manage it in advance.

预测接受髋关节置换术的老年患者术后谵妄的风险:新型提名图的开发与评估
目的在接受髋关节置换术的老年人群中构建并在内部验证一种预测术后谵妄可能性的提名图:回顾性收集了接受髋关节置换术的 681 名老年患者的数据,并按照 7:3 的时间分布原则将其分为模型队列(477 人)和验证队列(204 人)。术后认知功能的评估采用混乱评估法(CAM)进行。通过拉索回归和逻辑回归相结合的方法建立了术后认知障碍的提名图模型。使用接收者操作特征曲线(ROC)、校准图和决策曲线分析(DCA)来评估其性能:提名图利用各种预测因素,包括年龄、体重指数(BMI)、教育程度、术前 Barthel 指数、术前血红蛋白水平、糖尿病史和脑血管疾病史,预测患者术后谵妄的可能性。包含上述预测因素的提名图的 ROC 曲线下面积(AUC)在训练集为 0.836(95% CI:0.797-0.875),在验证集为 0.817(95% CI:0.755-0.880)。两组数据的校准曲线显示,提名图的预测结果与实际概率之间的一致性很好:使用这种新型提名图可以帮助临床医生预测老年患者在髋关节置换术后出现谵妄的可能性,有助于提前预防和处理谵妄。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
114
审稿时长
6-12 weeks
期刊介绍: Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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