关键词: 老年人, 术后亚谵妄综合征, 腹部手术, 预测模型, 列线图, 护理

Abstract:

Objective To analyze the influencing factors of postoperative subsyndromal delirium in elderly patients undergoing abdominal surgery，and to develop a nomogram risk prediction model. Methods A convenience sampling method was used to select 497 elderly patients who underwent abdominal surgery in a tertiary hospital in Sichuan Province from February to October 2022. The risk prediction model and nomograms model were constructed using Logistic regression analysis and R software. The area under the subject’s working characteristic curve（AUC） and Hosmer-Lemshow test were used to evaluate the discrimination and calibration of the model. Results The results of Logistic regression showed that age（OR=1.066），functional activities（OR=1.143），patient controlled intravenous analgesia（OR=5.811），transanal drainage tube（OR=2.276） and postoperative blood transfusion （OR=4.322） were independent influences on the occurrence of postoperative subsyndromal delirium. The p-values of the prediction model in both the training and validation sets were greater than 0.05；the area under the ROC curves were 0.734 and 0.691；the model was presented in the form of nomogram. Conclusion The prediction model developed in this study has good discrimination and accuracy. It can be used to assist clinical staff in identifying patients at high risk of developing postoperative subsyndromal delirium and provide the reference for developing preventive and intervention measures.

Key words: Aged, Postoperative Subsyndromal Delirium, Abdominal Surgery, Prediction Model, Nomogram, Nursing Care