ArticleWorld journal of psychiatry2025
Developing a nomogram for postoperative delirium in elderly patients with hip fractures.
Article in World journal of psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Development and multicenter validation of a dynamic nomogram for early postoperative neurocognitive disorder in older adults with hip fracture.BMC geriatrics · 2026Article
- Development and internal validation of a perioperative nomogram for predicting post-operative delirium in geriatric patients with intertrochanteric fractures undergoing internal fixation with pre-operative low-dose dexamethasone.Frontiers in medicine · 2026Article
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8 authors.
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Abstract
backgroundPostoperative 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.
aimTo investigate POD incidence in elderly patients with HF and the independent risk factors, according to which a nomogram prediction model was developed and validated.
methodsThis retrospective study included elderly patients with HF who were surgically treated in Dongying People's Hospital from April 2018 to April 2022. The endpoint event includes POD. They were categorized into the modeling and validation cohorts in a 7:3 ratio by randomization. Both cohorts were further classified into the delirium and normal (non-delirium) groups according to the presence or absence of the endpoint event. The incidence of POD was calculated, and logistic multivariate analysis was conducted to determine the independent risk factors. The calibration curve and the Hosmer-Lemeshow test as well as the net benefit threshold probability interval by the decision curve were utilized to statistically validate the accuracy of the nomogram prediction model, 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 of baseline data with perioperative indicators revealed statistical differences in age (
conclusionThis study reveals cognitive impairment history, American Society of Anesthesiologists grade of > 2, RBC transfusion of ≥ 2 units, postoperative intensive care unit care, and preoperative hemoglobin level as independent risk factors for POD in elderly patients with HF. The developed nomogram model demonstrates excellent accuracy and stability in predicting the risk of POD, which is recommended to be applied in clinical practice to optimize postoperative management and reduce delirium incidence.
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