{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T08:02:13Z","timestamp":1772006533306,"version":"3.50.1"},"reference-count":0,"publisher":"Annali Italiani di Chirurgia","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann. Ital. Chir."],"abstract":"<jats:p>AIM: To analyze the influencing factors of postoperative delirium (POD) after intraspinal anesthesia in elderly patients undergoing femoral neck fracture (FNF) surgery and to construct a prediction model for early identification of high-risk patients. METHODS: This retrospective study included 407 elderly patients who underwent FNF surgery under spinal anesthesia from January 2020 to January 2024 as the modeling cohort; and another 82 patients who underwent similar surgery under spinal anesthesia between February 2024 and February 2025, according to the same inclusion and exclusion criteria, as an independent time-limited external validation cohort. Data were collected from the hospital's electronic medical records. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for POD. A nomogram prediction model was constructed and validated internally and externally. RESULTS: The incidence of POD was 16.95% (69\/407). Independent risk factors identified were age &gt;80 years (odds ratio (OR) = 2.25, 95% CI: 1.25\u20134.05, p = 0.007), diabetes (OR = 1.91, 95% CI: 1.03\u20133.56, p = 0.041), preoperative hemoglobin &lt;90 g\/L (OR = 2.11, 95% CI: 1.14\u20133.90, p = 0.017), preoperative albumin &lt;30 g\/L (OR = 3.76, 95% CI: 1.95\u20137.25, p &lt; 0.001), preoperative waiting time \u22653 days (OR = 2.62, 95% CI: 1.40\u20134.90, p = 0.003), American Society of Anesthesiologists (ASA) grade \u2265III (OR = 2.12, 95% CI: 1.08\u20134.17, p = 0.029), postoperative hypoxemia (OR = 2.22, 95% CI: 1.22\u20134.05, p = 0.009), and postoperative visual analog scale (VAS) score \u22654 (OR = 2.55, 95% CI: 1.39\u20134.68, p = 0.002). The nomogram exhibited strong discriminative ability (area under the curve (AUC) = 0.79 for internal, 0.85 for external validation) and satisfactory calibration (Hosmer\u2013Lemeshow p &gt; 0.05). CONCLUSIONS: This study identified independent risk factors for POD after intraspinal anesthesia in elderly FNF patients and established a nomogram with excellent predictive ability, offering a reliable tool for early detection of high-risk cases and facilitating implementation of targeted preventive measures.<\/jats:p>","DOI":"10.62713\/aic.4257","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T06:18:38Z","timestamp":1770617918000},"source":"Crossref","is-referenced-by-count":0,"title":["Analysis of Influencing Factors and Construction of Prediction Model for Delirium After Intraspinal Anesthesia in Elderly Patients Undergoing Femoral Neck Fracture Surgery"],"prefix":"10.62713","volume":"97","author":[{"given":"Juan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"XiuFeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, 100020 Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"48935","published-online":{"date-parts":[[2026,2,9]]},"container-title":["Annali Italiani di Chirurgia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.annaliitalianidichirurgia.it\/journal\/AIC\/97\/2\/10.62713\/aic.4257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:05:55Z","timestamp":1772003155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.annaliitalianidichirurgia.it\/journal\/AIC\/97\/2\/10.62713\/aic.4257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"alternative-id":["S0003-469X(26)00027-0"],"URL":"https:\/\/doi.org\/10.62713\/aic.4257","relation":{},"ISSN":["0003-469X","2239-253X"],"issn-type":[{"value":"0003-469X","type":"print"},{"value":"2239-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"article-number":"317"}}