Establishment and verification of a nomogram of postoperative de lirium in elderly patients undergoing thoracic surgery
Zheng Shu1，Zhou Peimin2，lü Zhenye1， Fu Xiangshang1，Feng Rui1
1 Department of Thoracic Surgery, Wenzhou People′s Hospital, Wenzhou 325000, China;
2 Department of Orthopedics, Wenzhou People′s Hospital, Wenzhou 325000, China
Abstract：Objective To establish a nomogram to predict the risk of postoperative delirium (POD) in elderly patients undergoing thoracic surgery and to verify the accuracy of the model. Methods All elderly patients who underwent thoracic surgery from December 2018 to December 2020 in Wenzhou People′s Hospital were included in this retrospective study. A least absolute shrinkage and selection operator (LASSO) regression model was used to reduce data dimensionality and determine the best predictors for inclusion in the nomogram. Multivariable logistic regression analysis was applied to establish the prediction model represented by a nomogram incorporating the selected feature variables. The predicting model′s characteristics of the discrimination, calibration and clinical applicability were analyzed using the-C-index, the calibration diagram, and the decision curve. Results Five variables, including age, diabetes mellitus, NRS-2002 score, Pittsburgh sleep index, and operation time, were identified and applied to develop a nomogram. With a -C-index of 0.798, the model showed good discrimination. The calibration diagram and the Hosmer-Lemeshow test indicated well agreement between the probability as predicted by the nomogram and the actual probability. The decision curve analysis indicated that the nomogram could be applied clinically if the risk threshold was between 11% and 93. Conclusion The nomogram, incorporating age, diabetes mellitus, NRS-2002 score, Pittsburgh sleep index, and operation time, was an individualized, predictive model of clinical significance, which may help medical staff early identify postoperative delirium in elderly patients undergoing thoracic surgery.
郑舒，周佩敏，吕振业，付向上，冯锐. 老年胸外科患者术后谵妄列线图模型的建立与评价[J]. 中国医院统计, 2021, 28(4): 305-310.
Zheng Shu， Zhou Peimin，lü Zhenye， Fu Xiangshang， Feng Rui. Establishment and verification of a nomogram of postoperative de lirium in elderly patients undergoing thoracic surgery. journal1, 2021, 28(4): 305-310.
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