|Table of Contents|

Establishment and evaluation of a nomogram model for delirium occurrence after thoracoscopic radical resection in elderly lung cancer patients

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 06
Page:
1054-1059
Research Field:
Publishing date:

Info

Title:
Establishment and evaluation of a nomogram model for delirium occurrence after thoracoscopic radical resection in elderly lung cancer patients
Author(s):
LIU Wei; GUAN Dandan; ZHANG Hongyan
First Department of Thoracic Surgery,Shengjing Hospital Affiliated to China Medical University,Liaoning Shenyang 110004,China.
Keywords:
thoracoscopy; lung cancer; delirium; nomogram model
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2024.06.012
Abstract:
Objective:To analyze the risk factors of delirium after thoracoscopic radical resection in elderly patients with lung cancer,build an individualized nomogram model based on the above influencing factors,and verify the prediction accuracy and clinical validity of the nomogram model.Methods:The clinical data of elderly patients with lung cancer who underwent thoracoscopic radical resection of lung cancer in our hospital from January 1,2016 to January 1,2021 were retrospectively analyzed,and eligible patients were selected,and postoperative delirium was used as the outcome variable.The effects of patient-related clinical indicators,perioperative-related indicators,and experimental-related indicators on the occurrence of postoperative delirium were explored.Univariate and multivariate logistical analysis was used to analyze the risk factors of delirium after thoracoscopic resection of lung cancer in elderly patients.The R language package was used to construct a nomogram model,and the Bootstrap method and the clinical decision curve were used to verify the accuracy of the model and the benefit of clinical decision-making.Results:A total of 284 patients were finally included.Among the 284 patients,32 patients had postoperative delirium,and the incidence rate was 11.27%.The multivariate logistic analysis showed that the independent risk factors for postoperative delirium were:History of COPD,PO2,BMI,ASA classification,intraoperative one-lung ventilation time,intraoperative propofol dosage,and postoperative dezocine dosage.ROC curve validation nomogram model showed:The ability of constructed nomogram individually predicting the delirium after thoracoscopic resection of elderly lung cancer was strong,with AUC=0.858,95%CI 0.71~0.92,and then the Bootstrap method was used to repeat sampling 1 000 times to verify the nomogram,and it was found that the mean absolute error of the calibration curve was 0.016,indicating that the calibration curve could fit the ideal curve well.The clinical decision curve showed that the nomogram model has the best applicability when the threshold for delirium after thoracoscopic radical resection of elderly lung cancer was between 0.06 and 0.87.Conclusion:The independent risk factors for delirium after thoracoscopic radical resection in elderly patients with lung cancer are COPD,PO2,BMI,ASA classification,intraoperative one-lung ventilation time,intraoperative propofol dosage and postoperative dezocine dosage.The nomogram model constructed by risk factors is accurate in predicting delirium after thoracoscopic radical resection of lung cancer in elderly patients,and has high clinical application value.

References:

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辽宁省教育厅科学研究经费项目（编号：QN2019015）
Last Update: 1900-01-01