Construction and verification of a nomogram for neurocognitive impairment during the perioperative period of hip replacement surgery in the elderly
CAI Dan
ZHOU Yujiao
ZHANG Chen
Abstract：Objective To explore the risk factors of perioperative neurocognitive impairment(PND)in elderly patients undergoing hip replacement surgery,and to construct a nomogram model based on the risk factors.Methods The clinical data of 200 elderly patients who underwent hip arthroplasty in the Internal Medicine Department of Beijing Delcony Orthopedic Hospital from March 2023 to March 2025 were retrospectively analyzed and divided into two groups:71 cases in the PND group and 129 cases in the non-PND group.The clinical relevant information(such as gender and age)of all research subjects was collected for analysis and comparison.Univariate and multivariate logistic regression analyses were conducted.A nomogram prediction model was constructed based on significant variables and verified.Results Gender,age,body mass index(BMI),respiratory diseases,operation time,anesthesia time,intraoperative blood loss,smoking history,drinking history,hypertension,hyperlipidemia,type of replacement,case number of different operation durations,intraoperative blood loss,nursing methods,red blood cell count(RBC),white blood cell count(WBC),neutrophil count(NEU),and lymphocyte count(LYM)were not associated with perioperative PND in elderly patients undergoing hip replacement surgery(P>0.05).Frailty score,diabetes,anesthesia method,analgesia plan,Visual Analogue Scale(VAS)score for postoperative pain,hemoglobin(HB)and albumin(ALB)were related to perioperative PND in elderly patients undergoing hip replacement(P<0.05).High frailty score,diabetes,general anesthesia,single analgesic regimen,and high VAS score were independent risk factors for perioperative PND in elderly patients undergoing hip replacement surgery(P<0.05).High levels of HB and ALB were protective factors for perioperative PND in elderly patients undergoing hip replacement surgery(P<0.05).The area under the curve(AUC)of the nomogram prediction model for perioperative concurrent PND in elderly patients undergoing hip replacement was 0.875(95%CI:0.812～0.901).Conclusion High frailty score,general anesthesia,single analgesia regimen,and excessively high VAS score are independent risk factors for perioperative PND in elderly patients undergoing hip replacement surgery.According to the constructed nomogram prediction model for perioperative concurrent PND in elderly patients undergoing hip replacement surgery,it has good discrimination and consistency.
Keywords：hip replacement surgery for the elderlyneurocognitive impairmentrisk factorsnomogrampredictive model
Publication Date：2025-10-20
Online Publishing Date：2025-12-11(First online date of this platform, not the publication date of the document)
Pages：6( 33-38 )