A predictive nomogram model for postoperative delirium in elderly patients following laparoscopic surgery for gynecologic cancers

Background This study aimed to investigate potential risk factors associated with postoperative delirium (POD) in elderly patients following laparoscopic surgery for gynecologic cancers and construct a nomogram predictive model based on these factors. Methods Eligible elderly patients who underwent laparoscopic surgery for gynecologic cancers were enrolled and grouped according to the development of POD within postoperative 7 days. Potential risk factors were assessed by the univariate and multivariate logistic regression analyses. A nomogram model was constructed based on these factors and evaluated by R. Results A total of 226 elderly patients were enrolled in the final data analysis and 39 patients had suffered POD with an incidence of 17.3%. Older age, modified frailty index (mFI) & GE; 0.225, C-reactive protein (CRP) & GE; 8.0, systemic immune-inflammation index (SII), and albumin/fibrinogen ratio (AFR) were five independent risk factors for POD by univariate and multivariate analyses. The area under the curve (AUC) of the constructed nomogram model based on these five factors was 0.833. Conclusions The constructed nomogram model based on age, CRP, SII, mFI, and AFR could effectively predict POD in elderly patients with gynecologic cancers.