Objective  To analyze the risk factors of post-operative delirium in elderly pa-tients with a femoral neck fracture after arthroplasty and construct a Nomogram prediction model.

Methods  A retrospectively analysis was conducted for the clinical data of 195 patients with femoral neck fracture over 65 years old who underwent arthroplasty at Yantaishan Hospital from January 2019 to December 2020. Baseline data, the items of routine blood test, inflammatory test, biochemical test, coagulation test and D-Dimer as well as arterial blood gas were recorded. According to whether delirium happened after surgery, the patients were divided into delirium group and non-delirium group to analyze the incidence of delirium. Lasso regression and multivariate logistic regression were used to analyze and investigate the risk factors of delirium, and then Nomogram prediction model was established.

Results  The incidence of postoperative delirium (POD) after arthroplasty was 16.4%. The Lasso-Logistic regression model showed that gender (OR=0.16, 95%CI 0.06 to 0.44), type of sur-gery (OR=3.26, 95%CI 1.02 to 10.37), albumin (OR=1.19, 95%CI 1.03 to 1.38) were independent risk factors of POD. The AUC was 0.833, suggesting that the Nomogram prediction model has good predic-tion ability and accuracy.

Conclusion  Gender, age, types of surgery and albumin are independent risk factors of POD.The Nomogram prediction model can easily predict the risk of POD.

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