Correlation of intraoperative blood pressure variability and postoperative delirium in elderly hip fracture surgery

Figures

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  Fig. 1. Flow diagram of enrollment.

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  Fig. 2. Relationship between different intraoperative CV-MAP level groups and POD rates in patients with hip fracture before and after PSM. (a) Mean and standard deviation of CV-MAP levels between the POD group and without POD group before PSM. (b) Comparison of POD rates before PSM based on intraoperative CV-MAP (CV-MAP ≤ 10% vs. > 10%). (c) Patients were categorized into 3 groups using tertiles, comparing POD rates among the 3 groups before PSM. (d) Mean and standard deviation of CV-MAP levels between the POD group and without POD group after PSM. (e) Comparison of POD rates after PSM based on intraoperative CV-MAP (CV-MAP ≤ 10% vs. > 10%). (f) Patients were categorized into 3 groups using tertiles, comparing POD rates among the 3 groups after PSM.

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  Fig. 3. Relationship between intraoperative Mean − MAP levels and POD in patients with hip fracture. (a) Adjusted odds ratios (ORs) for postoperative delirium across intraoperative mean-MAP levels—showing a U-shaped pattern—include ORs and 95% confidence intervals (CIs) for 10 mmHg deviation from the reference value of intraoperative Mean − MAP levels. (b) Predicted probabilities and the observed rate of POD based on CV-MAP.

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  Fig. 4. Relationship between intraoperative Mean − SBP levels and POD in patients with hip fracture. (a) Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are shown for 10 mmHg deviation away from the reference value of intraoperative Mean − SBP levels. (b) Predicted probabilities and the observed rate of POD based on CV-SBP.

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  Fig. 5. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) are shown for each 5% deviation away from the reference value of intraoperative CV-MAP level. A logistic regression model was first fitted, incorporating restricted cubic spline transformations for CV-MAP to capture its non-linear association with postoperative delirium. Based on the model’s coefficients and spline transformations, predicted adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated for different CV-MAP values. These results were then visualized to illustrate the relationship between intraoperative CV-MAP levels and adjusted ORs for POD.

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  Fig. 6. Subgroup analysis of association CV-MAP and POD after propensity score matching.