Abstract
OBJECTIVE: The objective of this study was to develop and validate a clinically applicable nomogram for predicting the risk of delirium following hepatectomy. METHODS: We applied the LASSO regression model to identify the independent risk factors associated with POD. Subsequently, we utilized R software to develop and validate a nomogram model capable of accurately predicting the incidence of POD. RESULTS: The final variables selected by the LASSO method were: Ramelteon, Age, Sex, Alcohol, Viral status, Cardiovascular disease, ASA class, Total bilirubin, Prothrombin time, Laparoscopic approach, and Blood transfusion. The performance of the nomogram was measured using ROC curve analysis, with an AUC of 0.854 (95% CI: 0.794-0.914) for the model. At the optimal cutoff value, the model demonstrated a sensitivity of 91.9% and a specificity of 68.8%. Model validation was performed using internal bootstrap validation to further verify the regression analysis. The ROC curve was generated by repeating the bootstrapping process 500 times, resulting in an AUC of 0.848 (95% CI: 0.786-0.904) for the model. The DCA curve representing the net benefit demonstrated the strong clinical validity of the model in predicting postoperative delirium. CONCLUSION: Our results demonstrated that LASSO-based regression effectively constructed a nomogram model for predicting post-hepatectomy delirium.