Influencing factors of neurocognitive dysfunction after total knee arthroplasty and the construction of a nomogram model
10.11958/20241375
- VernacularTitle:全膝关节置换术后神经认知功能障碍的影响因素及列线图模型的构建
- Author:
Fang JIA
1
;
Ping LI
1
;
Jing LI
1
;
Lu YIN
1
Author Information
1. 天津市天津医院麻醉科(邮编 300211)
- Publication Type:Journal Article
- Keywords:
arthroplasty,replacement,knee;
cognitive dysfunction;
Logistic models;
nomograms
- From:
Tianjin Medical Journal
2025;53(3):287-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors of neurocognitive dysfunction(PND)in patients with total knee arthroplasty(TKA)and construct a nomogram prediction model.Methods The clinical data of 249 patients with TKA admitted to our hospital from December 2022 to July 2024 were selected.Patients were divided into the modeling queue(n=174)and the verification queue(n=75)according to the ratio of 7∶3.At the same time,according to whether patients developed PND or not,the modeling queue was divided into the PND group(n=62)and the non-PND group(n=112),and the verification queue was divided into the PND group(n=27)and the non-PND group(n=48).The influencing factors of PND in TKA patients were analyzed,and a nomogram prediction model was established to verify.Results High debilitation score,general anesthesia,single analgesic regimen and high VAS score were risk factors of PND,while high albumin and hemoglobin levels were protective factors of PND(P＜0.05).The nomogram model was constructed,and the AUC of PND in the modeling queue and the verification queue was 0.875(95%CI:0.824-0.925)and 0.905(95%CI:0.835-0.975)respectively.The results of calibration curve analysis showed that the predicted risk of PND was basically consistent with the actual situation,and the results of Hosmer-Lemeshow showed that the model fit well.The results of clinical decision curve showed that the model had high clinical application value.Conclusion High debilitating score,general anesthesia,single analgesic regimen,high VAS score and low albumin and hemoglobin levels can increase the risk of PND in TKA patients.The nomogram prediction model constructed in this study is helpful for clinical identification of high-risk groups of PND.
