Development and Internal Validation of a Perioperative Nomogram for Predicting Postoperative Delirium in Geriatric Patients with Intertrochanteric Fractures Undergoing Internal Fixation with Preoperative Low-Dose Dexamethasone - Scorecard - MDSpire

Development and Internal Validation of a Perioperative Nomogram for Predicting Postoperative Delirium in Geriatric Patients with Intertrochanteric Fractures Undergoing Internal Fixation with Preoperative Low-Dose Dexamethasone

  • By

  • Liu, Wanshun

  • Lu, Yunxi

  • Chen, Jun

  • Lv, Yuanhao

  • Wa, Qingde

  • May 25, 2026

  • 0 min

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Clinical Scorecard: Creation and Internal Assessment of a Nomogram for Anticipating Postoperative Delirium in Elderly Individuals with Intertrochanteric Fractures Undergoing Internal Fixation Following Preoperative Low-Dose Dexamethasone Administration

At a Glance

CategoryDetail
ConditionPostoperative Delirium (POD)
Key MechanismsAge, preoperative monocyte count, postoperative transfer to ICU
Target PopulationElderly patients aged ≥60 years undergoing internal fixation for intertrochanteric fractures
Care SettingThird Affiliated Hospital of Zunyi Medical University

Key Highlights

  • Incidence of POD was 12.5% (31/248)
  • Three independent predictors identified: age, preoperative monocyte count, postoperative transfer to ICU
  • Nomogram demonstrated AUC of 0.803, accuracy of 0.843, sensitivity of 0.821, specificity of 0.847
  • Model validated using calibration curves and decision curve analysis
  • Standardized preoperative low-dose intravenous dexamethasone administered

Guideline-Based Recommendations

Diagnosis

  • Utilize the nomogram for predicting POD in geriatric patients

Management

  • Implement targeted preventive strategies for high-risk individuals identified by the nomogram

Monitoring & Follow-up

  • Monitor patients for signs of POD postoperatively, especially those with identified risk factors

Risks

  • Increased risk of POD associated with older age, higher preoperative monocyte count, and ICU transfer

Patient & Prescribing Data

Elderly individuals aged ≥60 years undergoing surgery for intertrochanteric fractures

Preoperative administration of 10 mg dexamethasone intravenously 30 minutes before surgery

Clinical Best Practices

  • Incorporate nomogram findings into preoperative assessments
  • Ensure thorough monitoring of high-risk patients post-surgery
  • Utilize standardized protocols for PONV prophylaxis

Related Resources & Content

    Original Source(s)

    Development and Internal Validation of a Perioperative Nomogram for Predicting Postoperative Delirium in Geriatric Patients with Intertrochanteric Fractures Undergoing Internal Fixation with Preoperative Low-Dose Dexamethasone

    • by Liu, Wanshun , Lu, Yunxi , Chen, Jun , Lv, Yuanhao , Wa, Qingde

    • May 25, 2026

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