Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3720-3728
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3720
Nomogram to predict postoperative complications in elderly with total hip replacement
Xiu-Juan Tan, Xiao-Xia Gu, Feng-Min Ge, Zhi-Yi Li, Liang-Qing Zhang
Xiu-Juan Tan, Department of Anesthesiology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, Guangdong Province, China
Xiao-Xia Gu, Feng-Min Ge, Zhi-Yi Li, Liang-Qing Zhang, Department of Anesthesiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
Author contributions: Tan XJ is first Author, participated in protocol writing, collecting data, statistical analysis, interpretation of results and manuscript writing; Ge FM helped collection of cases; Li ZY participated in protocol writing, essay writing; Gu XX helped interpretation of results and manuscript writing; Zhang LQ did the statistical analysis and reviewed the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Guangdong Medical University with the reference number PJ2020-022.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang-Qing Zhang, MD, PhD, Professor, Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, No. 57 South People's Avenue Xiashan District, Zhanjiang 524001, Guangdong Province, China. lngkkt@126.com
Received: October 28, 2021
Peer-review started: October 28, 2021
First decision: February 14, 2022
Revised: February 22, 2022
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: April 26, 2022
Processing time: 174 Days and 19.1 Hours
ARTICLE HIGHLIGHTS
Research background

As living standards and medical technology improve, the average lifespan and demand for medical care are gradually increasing, and the number of total hip replacements in elderly individuals is also increasing. Patients who undergo total hip replacement often experience trauma, pain, bleeding, and immobilization, leading to a cascade of inflammatory and metabolic processes that lead to severe postoperative complications. Numerous clinical tools have been developed to predict a variety of THA patient outcomes, but these risk calculators are poor predictors of postoperative complications in Chinese patients. The aim of this study was to analyse and assess postoperative complications and develop a nomogram model based on the related risk factors in elderly patients who underwent total hip replacement to guide surgeons and anaesthesiologists in developing strategies to minimize complications in elderly patients.

Research motivation

Develop a nomogram model to provide scientific guidance for the individualized prevention and treatment of postoperative complications in elderly patients who underwent total hip replacement.

Research objectives

To develop a nomogram model based on preoperative and intraoperative variables to predict postoperative complications in elderly patients who underwent total hip replacement.

Research methods

We collected the clinical data of all patients who underwent total hip replacement from March 1, 2017 to August 31, 2019 at the Affiliated Hospital of Guangdong Medical University, including patient information, comorbidities, laboratory test results, intraoperative variables, and postoperative complications during hospitalization. The STATA 14.0 statistical software package and R software (R3.2.3) were used to develop a nomogram to predict the risk of postoperative complications in elderly patients who underwent total hip replacement surgery. The nomogram model can predict the risk of adverse clinical events individually by quantifying and visually displaying the results of the logistic regression.

Research results

Age, diabetes, renal failure, and albumin value were independent risk factors for postoperative complications in elderly patients who underwent total hip replacement surgery.

Research conclusions

The nomogram model can integrate the related risk factors and predict the risk of adverse clinical events for individual patients and provide scientific guidance for the individualized clinical prevention and treatment of postoperative complications in elderly patients who underwent total hip replacement surgery.

Research perspectives

We will increase the sample size used to construct the model, perform prolonged follow-up, and conduct a multicenter study in the future.