Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture
Yuansheng Xu,1 Yongjun Luo2 1Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Orthopedics, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215123, People’s Republic of ChinaCorrespond...
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Dove Medical Press
2025-07-01
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| description | Yuansheng Xu,1 Yongjun Luo2 1Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Orthopedics, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215123, People’s Republic of ChinaCorrespondence: Yongjun Luo, Email lyjnjmu@163.comObjective: This study aimed to investigate the potential risk factors of postoperative delirium (POD) in elderly patients (≥ 65 years old) undergoing femoral neck fracture (FNF) surgery, and explore whether preoperative prognostic nutritional index (PNI) could predict the occurrence of POD.Methods: A total of 260 cases with FNF were included in this study at The Affiliated Jinling Hospital of Nanjing University from May 2018 and May 2024. The baseline characteristics were recorded. The receiver operating characteristic (ROC) curve analysis was developed to evaluate the diagnostic ability of preoperative PNI for POD. LASSO regression and multivariate logistic regression analyses were used to identify the risk factors for POD.Results: Eighty-one of the 260 cases with FNF suffered POD with an incidence of 31.2%. Patients with POD showed lower Mini-Mental State Examination (MMSE) score (P=0.011), lymphocyte count (P=0.002), albumin level (P=0.011), and PNI level (P< 0.001) than those in non-POD group. ROC curve analysis indicated that PNI was a good predictor for POD with an area under the curve (AUC) value of 0.708 (95% CI: 0.648– 0.762, P< 0.001); the sensitivity and specificity were 79.01 and 60.89, respectively. LASSO regression analysis identified eleven key variables including gender, age, body mass index, diabetes mellitus, surgery duration, anesthesia duration, fracture position, neutrophil, lymphocyte, PNI, and MMSE score. Multivariate logistic regression analysis showed that MMSE score < 27, BMI > 23.9 kg/m2, and PNI < 45.45 were independent risk factors of POD.Conclusion: In conclusion, preoperative PNI is a significant predictor for POD in elderly patients after FNF surgery.Keywords: postoperative delirium, femoral neck fracture, prognostic nutritional index, predictor |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-07-01 |
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| series | Clinical Interventions in Aging |
| spelling | doaj-art-747453075af14d0d8d39a2a172584bc92025-08-20T03:28:25ZengDove Medical PressClinical Interventions in Aging1178-19982025-07-01Volume 20Issue 1941950104404Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck FractureXu YLuo YYuansheng Xu,1 Yongjun Luo2 1Department of Orthopedics, The Affiliated Jinling Hospital of Nanjing University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Orthopedics, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215123, People’s Republic of ChinaCorrespondence: Yongjun Luo, Email lyjnjmu@163.comObjective: This study aimed to investigate the potential risk factors of postoperative delirium (POD) in elderly patients (≥ 65 years old) undergoing femoral neck fracture (FNF) surgery, and explore whether preoperative prognostic nutritional index (PNI) could predict the occurrence of POD.Methods: A total of 260 cases with FNF were included in this study at The Affiliated Jinling Hospital of Nanjing University from May 2018 and May 2024. The baseline characteristics were recorded. The receiver operating characteristic (ROC) curve analysis was developed to evaluate the diagnostic ability of preoperative PNI for POD. LASSO regression and multivariate logistic regression analyses were used to identify the risk factors for POD.Results: Eighty-one of the 260 cases with FNF suffered POD with an incidence of 31.2%. Patients with POD showed lower Mini-Mental State Examination (MMSE) score (P=0.011), lymphocyte count (P=0.002), albumin level (P=0.011), and PNI level (P< 0.001) than those in non-POD group. ROC curve analysis indicated that PNI was a good predictor for POD with an area under the curve (AUC) value of 0.708 (95% CI: 0.648– 0.762, P< 0.001); the sensitivity and specificity were 79.01 and 60.89, respectively. LASSO regression analysis identified eleven key variables including gender, age, body mass index, diabetes mellitus, surgery duration, anesthesia duration, fracture position, neutrophil, lymphocyte, PNI, and MMSE score. Multivariate logistic regression analysis showed that MMSE score < 27, BMI > 23.9 kg/m2, and PNI < 45.45 were independent risk factors of POD.Conclusion: In conclusion, preoperative PNI is a significant predictor for POD in elderly patients after FNF surgery.Keywords: postoperative delirium, femoral neck fracture, prognostic nutritional index, predictorhttps://www.dovepress.com/preoperative-prognostic-nutritional-index-is-a-predictive-factor-for-p-peer-reviewed-fulltext-article-CIApostoperative deliriumfemoral neck fractureprognostic nutritional indexpredictor |
| spellingShingle | Xu Y Luo Y Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture Clinical Interventions in Aging postoperative delirium femoral neck fracture prognostic nutritional index predictor |
| title | Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture |
| title_full | Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture |
| title_fullStr | Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture |
| title_full_unstemmed | Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture |
| title_short | Preoperative Prognostic Nutritional Index Is a Predictive Factor for Postoperative Delirium in Elderly Patients with Femoral Neck Fracture |
| title_sort | preoperative prognostic nutritional index is a predictive factor for postoperative delirium in elderly patients with femoral neck fracture |
| topic | postoperative delirium femoral neck fracture prognostic nutritional index predictor |
| url | https://www.dovepress.com/preoperative-prognostic-nutritional-index-is-a-predictive-factor-for-p-peer-reviewed-fulltext-article-CIA |
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