{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:16:26Z","timestamp":1789186586904,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To systematically evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Risk prediction models for postoperative delirium in older adult hip fracture patients were collected from the Cochrane Library, PubMed, Web of Science, and Ovid via the internet, covering studies from the establishment of the databases to March 15, 2023. Two researchers independently screened the literature, extracted data, and used Stata 13.0 for meta-analysis of predictive factors and the Prediction Model Risk of Bias Assessment Tool (PROBAST) to evaluate the risk prediction models for postoperative delirium in older adult hip fracture patients, evaluated the predictive performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This analysis included eight studies. Six studies used internal validation to assess the predictive models, while one combined both internal and external validation. The Area Under Curve (AUC) for the models ranged from 0.67 to 0.79. The most common predictors were preoperative dementia or dementia history (OR\u2009=\u20093.123, 95% CI 2.108\u20134.626, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001), American Society of Anesthesiologists (ASA) classification (OR\u2009=\u20092.343, 95% CI 1.146\u20134.789, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05), and age (OR\u2009=\u20091.615, 95% CI 1.387\u20131.880, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). This meta-analysis shows that these were independent risk factors for postoperative delirium in older adult patients with hip fracture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Research on the risk prediction models for postoperative delirium in older adult hip fracture patients is still in the developmental stage. The predictive performance of some of the established models achieve expectation and the applicable risk of all models is low, but there are also problems such as high risk of bias and lack of external validation. Medical professionals should select existing models and validate and optimize them with large samples from multiple centers according to their actual situation. It is more recommended to carry out a large sample of prospective studies to build prediction models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p>The protocol for this systematic review was published in the International Prospective Register of Systematic Reviews (PROSPERO) under the registered number CRD42022365258.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1226473","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T09:36:57Z","timestamp":1694770617000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk prediction models for postoperative delirium in elderly patients with hip fracture: a systematic review"],"prefix":"10.3389","volume":"10","author":[{"given":"Yaqi","family":"Hua","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianting","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"CPG1","DOI":"10.2519\/jospt.2021.0301","article-title":"Physical therapy Management of Older Adults with hip Fracture","volume":"51","author":"McDonough","year":"2021","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1007\/s00198-011-1601-6","article-title":"Secular trends in the incidence of hip and other osteoporotic fractures","volume":"22","author":"Cooper","year":"2011","journal-title":"Osteoporos Int"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.afos.2018.03.003","article-title":"An updated hip fracture projection in Asia: the Asian Federation of Osteoporosis Societies study","volume":"4","author":"Cheung","year":"2018","journal-title":"Osteoporos Sarcopenia"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e1291","DOI":"10.5435\/JAAOS-D-22-00125","article-title":"AAOS clinical practice guideline summary: Management of hip Fractures in older adults","volume":"30","author":"O'Connor","year":"2022","journal-title":"J Am Acad Orthop Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.bja.2020.06.063","article-title":"Postoperative delirium: perioperative assessment, risk reduction, and management","volume":"125","author":"Jin","year":"2020","journal-title":"Br J Anaesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"960364","DOI":"10.3389\/fnagi.2022.960364","article-title":"Risk factors for postoperative delirium in geriatric patients with hip fracture: a systematic review and meta-analysis","volume":"14","author":"Qi","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"21514593211062277","DOI":"10.1177\/21514593211062277","article-title":"Prediction of postoperative delirium in geriatric hip fracture patients: a clinical prediction model using machine learning algorithms","volume":"12","author":"Oosterhoff","year":"2021","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"51","DOI":"10.7326\/M18-1376","article-title":"PROBAST: a tool to assess the risk of Bias and applicability of prediction model studies","volume":"170","author":"Wolff","year":"2019","journal-title":"Ann Intern Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1111\/nep.13913","article-title":"Appraising prediction research: a guide and meta-review on bias and applicability assessment using the prediction model risk of Bias ASsessment tool (PROBAST)","volume":"26","author":"de Jong","year":"2021","journal-title":"Nephrology (Carlton)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1111\/j.1479-8301.2006.00146.x","article-title":"Predicting post-operative delirium in elderly patients undergoing surgery for hip fracture","volume":"6","author":"Goldenberg","year":"2006","journal-title":"Psychogeriatrics"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1213\/ANE.0000000000004386","article-title":"Development of a risk score to predict postoperative delirium in patients with hip fracture","volume":"130","author":"Kim","year":"2020","journal-title":"Anesth Analg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"104368","DOI":"10.1016\/j.archger.2021.104368","article-title":"Development of a postoperative delirium risk scoring tool using data from the Australian and New Zealand hip fracture registry: an analysis of 6672 patients 2017-2018","volume":"94","author":"Oberai","year":"2021","journal-title":"Arch Gerontol Geriatr"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e32420","DOI":"10.1002\/brb3.2420","article-title":"Identification of risk factors for postoperative delirium in elderly patients with hip fractures by a risk stratification index model: a retrospective study","volume":"11","author":"Wang","year":"2021","journal-title":"Brain Behav"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"914002","DOI":"10.3389\/fnagi.2022.914002","article-title":"Development and validation of a nomogram for predicting postoperative delirium in patients with elderly hip fracture based on data collected on admission","volume":"14","author":"Yang","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/j.injury.2018.10.034","article-title":"Predictive nomogram for postoperative delirium in elderly patients with a hip fracture","volume":"50","author":"Zhang","year":"2019","journal-title":"Injury"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"634629","DOI":"10.3389\/fsurg.2021.634629","article-title":"Machine learning algorithm using electronic chart-derived data to predict delirium after elderly hip fracture surgeries: a retrospective case-control study","volume":"8","author":"Zhao","year":"2021","journal-title":"Front Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e20.00221","DOI":"10.5435\/JAAOSGlobal-D-20-00221","article-title":"Predictors and sequelae of postoperative delirium in a geriatric patient population with hip fracture","volume":"5","author":"Haynes","year":"2021","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"7467","DOI":"10.3390\/ijerph17207467","article-title":"Predictors of delirium in octogenarian patients hospitalized for a hip fracture","volume":"17","author":"Plaza-Carmona","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s13018-018-0897-8","article-title":"Incidence and risk factors of postoperative delirium in the elderly patients with hip fracture","volume":"13","author":"Wang","year":"2018","journal-title":"J Orthop Surg Res"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.jclinane.2019.05.010","article-title":"Clinical predictors of postoperative delirium, functional status, and mortality in geriatric patients undergoing non-elective surgery for hip fracture","volume":"58","author":"Harris","year":"2019","journal-title":"J Clin Anesth"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s13018-020-02127-1","article-title":"Risk factors of postoperative delirium in the knee and hip replacement patients: a systematic review and meta-analysis","volume":"16","author":"Rong","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"106063","DOI":"10.1016\/j.ijsu.2021.106063","article-title":"Risk factors for postoperative delirium: An umbrella review of systematic reviews","volume":"93","author":"Bramley","year":"2021","journal-title":"Int J Surg"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2306","DOI":"10.1111\/j.1532-5415.2011.03725.x","article-title":"Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia","volume":"59","author":"Lee","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"146897","DOI":"10.1016\/j.brainres.2020.146897","article-title":"Evidence that the Kennedy and polyamine pathways are dysregulated in human brain in cases of dementia with Lewy bodies","volume":"1743","author":"Akyol","year":"2020","journal-title":"Brain Res"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"2799","DOI":"10.1038\/s41467-020-16629-3","article-title":"Polyamine regulation of ion channel assembly and implications for nicotinic acetylcholine receptor pharmacology","volume":"11","author":"Dhara","year":"2020","journal-title":"Nat Commun"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1007\/s11102-018-0886-2","article-title":"Management and consequences of postoperative fluctuations in plasma sodium concentration after pediatric brain tumor surgery in the sellar region: a national cohort analysis","volume":"21","author":"Kruis","year":"2018","journal-title":"Pituitary"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1186\/s12888-016-1130-0","article-title":"Electrolyte disorders and aging: risk factors for delirium in patients undergoing orthopedic surgeries","volume":"16","author":"Wang","year":"2016","journal-title":"BMC Psychiatry"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/anae.14569","article-title":"A review of ASA physical status \u2013 historical perspectives and modern developments","volume":"74","author":"Mayhew","year":"2019","journal-title":"Anaesthesia"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1097\/ALN.0000000000003947","article-title":"The evolution, current value, and future of the American Society of Anesthesiologists Physical Status Classification System","volume":"135","author":"Horvath","year":"2021","journal-title":"Anesthesiology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e1157","DOI":"10.1097\/SLA.0000000000005182","article-title":"American Society of Anesthesiologists-Physical Status Classification as An Independent Risk Factor of surgical site infection after infra-inguinal arterial bypass","volume":"277","author":"Tresson","year":"2021","journal-title":"Ann Surg"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1016\/j.ijsu.2015.04.079","article-title":"ASA class is a reliable independent predictor of medical complications and mortality following surgery","volume":"18","author":"Hackett","year":"2015","journal-title":"Int J Surg"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1302\/0301-620X.102B12.BJJ-2019-1537","article-title":"Factors associated with delirium and cognitive decline following hip fracture surgery","author":"Uzoigwe","year":"2020","journal-title":"Bone Joint J"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1097\/SLA.0000000000002347","article-title":"Age is the Most significantly associated risk factor with the development of delirium in patients hospitalized for more than five days in surgical wards: retrospective cohort study","volume":"267","author":"Kubota","year":"2018","journal-title":"Ann Surg"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1186\/s13054-014-0477-1","article-title":"Sleep-disordered breathing is a risk factor for delirium after cardiac surgery: a prospective cohort study","volume":"18","author":"Roggenbach","year":"2014","journal-title":"Crit Care"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1001\/jama.1996.03530350034031","article-title":"Precipitating factors for delirium in hospitalized elderly persons. Predictive model and interrelationship with baseline vulnerability","volume":"275","author":"Inouye","year":"1996","journal-title":"JAMA"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1002\/gps.1569","article-title":"Abnormal neurotransmitter metabolite levels in Alzheimer patients with a delirium","volume":"21","author":"van der Cammen","year":"2006","journal-title":"Int J Geriatr Psychiatry"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1038\/s41586-020-03160-0","article-title":"Restoring metabolism of myeloid cells reverses cognitive decline in ageing","volume":"590","author":"Minhas","year":"2021","journal-title":"Nature"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.ctrv.2016.04.002","article-title":"Balancing treatment efficacy, toxicity and complication risk in elderly patients with metastatic renal cell carcinoma","volume":"46","author":"van den Brom","year":"2016","journal-title":"Cancer Treat Rev"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"afab245","DOI":"10.1093\/ageing\/afab245","article-title":"New horizons in the perioperative care of older adults","volume":"51","author":"Thillainadesan","year":"2022","journal-title":"Age Ageing"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"W1","DOI":"10.7326\/M18-1377","article-title":"PROBAST: a tool to assess risk of Bias and applicability of prediction model studies: explanation and elaboration","volume":"170","author":"Moons","year":"2019","journal-title":"Ann Intern Med"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"W1","DOI":"10.7326\/M14-0698","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): explanation and elaboration","volume":"162","author":"Moons","year":"2015","journal-title":"Ann Intern Med"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"g7594","DOI":"10.1136\/bmj.g7594","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement","volume":"350","author":"Collins","year":"2015","journal-title":"BMJ"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1093\/eurheartj\/ehu207","article-title":"Towards better clinical prediction models: seven steps for development and an ABCD for validation","volume":"35","author":"Steyerberg","year":"2014","journal-title":"Eur Heart J"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1226473\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T09:37:02Z","timestamp":1694770622000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1226473\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,15]]},"references-count":43,"alternative-id":["10.3389\/fmed.2023.1226473"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1226473","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,15]]},"article-number":"1226473"}}