Abstract

Objective: To analyze the influencing factors of postoperative subdelirium syndrome in elderly patients undergoing orthopedic surgery and develop a predictive model. 

Methods: A convenience sampling method was used to select 312 elderly patients who underwent orthopedic surgery at a tertiary hospital in Guangdong province from January 2023 to August 2024. Univariate and multivariate logistic regression analyses were performed to explore the influencing factors of postoperative subdelirium syndrome. The prediction model was constructed using R software, and a receiver operating characteristic (ROC) curve was plotted. Model discrimination and calibration were evaluated using the area under the ROC curve (AUC), Hosmer-Lem shows test and calibration plot. 

Results: Multivariate logistic regression revealed that age (OR=1.059), scores on the Social Functioning Activities Questionnaire (SF AQ; OR=1.132), use of pain pumps postoperatively (OR=5.795), presence of wound drainage tubes (OR=2.268), and blood transfusion (OR=4.287) were independent risk factors for Postoperative Subsyndromal Delirium. The predictive model had P values >0.05 in both the modeling and validation groups, with AUCs of 0.727 and 0.688, respectively.

Conclusion: The developed predictive model for postoperative Subsyndromal Delirium in elderly patients undergoing orthopedic surgery demonstrates good calibration and discrimination. It can assist orthopedic clinicians in identifying high-risk patients for postoperative Subsyndromal Delirium, providing a reference for prevention and intervention strategies.