Risk Factors And Adverse Effects Of Postoperative Delirium After Hip Fracture Surgery

Objective:Explore the risk factors leading to postoperative delirium in patients with hip fractures,determine their correlation,establish a risk prediction model,analyze the adverse effects of delirium on patient rehabilitation,and provide guidance for clinical work Methods:Collect basic data of hip fracture patients who underwent surgical treatment at Huaihe Hospital of Henan University from 2018 to 2020.Divide the sample into delirium group and non delirium group based on whether postoperative delirium occurred.By analyzing various indicators during hospitalization,the collected data will include gender,age,BMI,intraoperative blood loss,surgical time,intraoperative hypotension,intraoperative hypoxia,preoperative anemia,resuscitation time,preoperative albumin level,anesthesia method History of excessive drinking,history of sedative use,history of stroke,history of hypertension,diabetes,sleep disorder,senile dementia,combined with other medical diseases,VAS score,ASA score,etc.The two groups of data were tested by Chi square test using R Studio(embedded R3.6.3),and the multivariate logistic regression equation of postoperative delirium risk factors was established.Using research results to establish a column chart model for risk prediction,draw ROC and DCA curves,and conduct internal validation to determine the accuracy of column chart prediction.Collect postoperative adverse events and include relevant postoperative data,such as hospital stay,whether there is aspiration,lung infection,bed fall,fracture,dislocation,lower limb thrombosis,extubation,wound infection,postoperative albumin,postoperative hemoglobin,etc.,for data analysis to clarify the adverse effects of postoperative delirium on patients.Results:A total of 193 patients who met the criteria were included in this study,with 82 patients experiencing postoperative delirium,accounting for approximately 45.60%.There was no statistical significance between the two groups in terms of gender,intraoperative blood loss,intraoperative low blood oxygen,resuscitation time,albumin level,history of excessive drinking,history of sedative use,history of hypertension,history of stroke,history of diabetes,history of senile dementia,and history of other medical diseases(p>0.05);There were statistically significant differences in BMI,surgical time,intraoperative hypotension,preoperative anemia,anesthesia methods,comorbidities with sleep disorders,VAS score,and ASA score(P<0.05).In multivariate logistic regression analysis,age,surgical time,intraoperative hypotension,preoperative anemia,sleep disorders,Vas score,are independent risk factors of postoperative delirium in hip fractures.Based on the results,establish a nomogram(column chart)to predict the study outcome.The ROC curve shows that the area under the curve AUC is 0.850,the Chi square value of the Hosmer Lemeshow test is 8.935,and P=0.348;The net return rate in the DCA curve is higher at any risk threshold.In the study on the adverse effects of postoperative delirium,there was no statistically significant difference between the two groups in terms of bed fall,fractures,dislocations,lower limb thrombosis,tube detachment,and wound infection(p>0.05);In terms of postoperative low albumin and hospitalization time,there was a statistically significant difference between the two groups(P<0.05),indicating that postoperative delirium can lead to an increase in hospitalization time and postoperative low albumin.Conclusion:This study found that postoperative delirium in hip fractures is related to age,surgical time,intraoperative hypotension,preoperative anemia,sleep disorders,and Vas score;The column chart model established in this study has high predictive efficiency and can be used in clinical work to predict the risk of postoperative delirium in hip fractures,providing reference for preventing postoperative delirium;Postoperative delirium can lead to an increase in hospital stay,a decrease in postoperative albumin,and affect patient recovery.