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Objective To explore the use of a novel inflammatory composite scoring system with a column chart model to predict the risk of postoperative delirium in patients with lumbar spine fractures. Methods 251 patients with lumbar spine fracture who had been admitted to our hospital and had undergone surgical treatment from June 2020 to December 2022 were selected as study subjects, and then divided into a postoperative delirium group （n = 55） and a delirium-free group （n = 196） according to the patients' conditions. The clinical data of the two groups were recorded and subjected to univariate analysis. ROC curve was used to analyze the predictive value of the indexes for postoperative delirium in the patients; logistic regression was used to analyse the independent risk factors for postoperative delirium and construct a columnar graph model; the calibration curves were used for the internal validation of the model; the consistency index （C-index） was calculated; and the decision curve was used to evaluate the predictive efficiency of the model. Results The differences between the two groups in terms of age, surgical duration, intraoperative bleeding, and inflammatory response markers NLR, PLR, and CAR were statistically significant （P < 0.05）. The AUCs of age, surgical time, intraoperative bleeding, NLR, PLR, and CAR were 0.788, 0.714, 0.797, 0.824, 0.839, and 0.811, respectively; and the AUC of the constructed N.P.Cs scoring scale was 0.963. Age, intraoperative bleeding, and N.P.Cs were independent risk factors affecting postoperative delirium in patients with lumbar spine fractures. The calibration curve of the column-line diagram prediction model was close to the original and ideal curves, with a C-index of 0.847 （95% CI:0.811 ~ 0.903）; the threshold value of the column-line diagram prediction model was greater than 0.17, providing a net clinical benefit. Conclusion Age, intraoperative bleeding, and N.P.Cs are independent risk factors for postoperative delirium in patients with lumbar spine fractures. The column chart prediction model based on this construction can provide guidance for the prevention and treatment of postoperative delirium in patients with lumbar spine fractures. [ABSTRACT FROM AUTHOR]

Objective To analyze the risk factors of recessive blood loss in patients with lumbar disc herniation after surgery and establish a nomogram prediction model. Methods Two hundred patients with lumbar disc herniation who came to our hospital from February 2019 to August 2022 were selected as the research objects. According to the recessive blood loss after surgery, the patients were divided into positive group （n = 85） and negative group （n = 115）. ROC experiment was used to analyze the predictive value of continuous variables. Logistic regression experiment was used to analyze the risk factors of recessive blood loss in patients with lumbar disc herniation after operation. Internal data were used to verify the clinical efficacy of Nomogram model. Results There was no significant difference in gender, BMI and other general data between the two groups （P > 0.05）. Compared with the negative group, the patients in the positive group were older, and they had more perioperative blood transfusions, larger number of surgical segments, higher TC and TG levels, and lower postoperative hemoglobin levels （P < 0.05）. The AUCs of age, number of operative segments, TC, TG and postoperative hemoglobin were 0.611, 0.607, 0.602, 0.673, 0.791, respectively, with the optimal cutoff values 39 years, 2 segments, 4.96 mmol/L, 6.79 mmol/L, 107 g/L, respectively. Age （> 39 years）, perioperative blood transfusion, number of operative segments （> 2 segments）, TC （> 4.96 mmol/L）, TG （> 6.79 mmol/L）, and hemoglobin difference （> 44 g/L） were all risk factors for recessive blood loss in the patients （P < 0.05）. Nomogram model predicted the risk of occult blood loss in the patients after surgery by a C-index of 0.775 （95% CI: 0.669 ~ 0.848）, with a risk threshold of recessive blood loss > 0.07. Nomogram model predictively yielded clinical net benefits as well. Conclusion Age （> 39 years）, perioperative blood transfusion, number of operative segments （> 2 segments）, TC （> 4.96 mmol/L）, TG （> 6.79 mmol/L）, and hemoglobin difference （> 44 g/L） are all risk factors that affect the occurrence of recessive blood loss in patients with lumbar disc herniation after surgery. Nomogram model based on the above variables can better predict the occurrence of recessive blood loss in those patients. [ABSTRACT FROM AUTHOR]