Development of a Nomogram-Based Prediction Model for Postoperative Delirium in Patients After Total Hip Arthroplasty: A Retrospective Cohort Study.

OBJECTIVES

To analyse risk factors for postoperative delirium (POD) in patients after total hip arthroplasty and develop a visual clinical prediction model.

DESIGN

A Retrospective Cohort Study.

METHODS

This study included 457 patients who received total hip arthroplasty. The clinical prediction model was developed based on the results of univariate and multivariate logistic regression analyses. The performance of the model was assessed through measures of discrimination, calibration and decision curve analysis. The final model was visualised as a nomogram. This study followed the TRIPOD checklist.

RESULTS

A nomogram was developed based on age, total protein, fall risk and catheterisation. The model demonstrated strong discriminative power, with an AUC of 0.867. There was a strong agreement between predicted and observed outcomes, as shown by calibration analysis, while DCA supported the model's favourable clinical applicability.

CONCLUSIONS

The predictive model developed in this study showed good discriminative performance and may support early clinical risk assessment of POD in patients undergoing total hip arthroplasty.

RELEVANCE TO CLINICAL PRACTICE: The importance of this research lies in shedding light on the significant impact of delirium on the health outcomes of patients after total hip arthroplasty, particularly in the short term. Guide clinical workers to identify risk factors early and improve the prognosis in patients after total hip arthroplasty.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Age, fall risk and catheterisation were independent risk factors for POD in patients after total hip arthroplasty; total protein levels were protective against it. This study offers nursing staff a visual, non-invasive and simple nomogram for calculating the risk probability of POD in patients underwent total hip arthroplasty. This study will help nursing staff to predict POD in patients at an early stage, and give personalised intervention measures to improve the prognosis.