To analyze the influencing factors of postoperative constipation in elderly patients with hip fracture, and construct a nomograph model of postoperative constipation in elderly patients with hip fracture, so as to provide help for personalized prevention and treatment of postoperative constipation in elderly patients with hip fracture.

A total of 131 patients with hip fracture admitted to The Second People's Hospital of Huai'an Hospital from February 2020 to February 2022 were selected by inclusion and exclusion criteria. Inclusion criteria: age≥60 years, ambulatory before bone fractures, falling height ≤body height, admission is within 24h. Exclusion criteria: multiple fractures or pathologic fractures, patients in critical condition, multiple organ injuries. The enrolled patients were grouped into constipation group and non constipation group according to whether they were constipation after operation. The general data [gender, age, body mass index (BMI)], past medical history (hypertension, heart disease, diabetes, cerebrovascular disease), operation methods (bone nail repair, total hip replacement, partial hip replacement), intraoperative conditions (anesthesia mode, operation methods, operation duration, intraoperative blood loss), time in bed after operation, use of probiotics and other data were compared between the two groups. According to the logistic regression analysis, the influencing factors of postoperative constipation in elderly hip fracture patients were analyzed, the R language was applied to construct an nomograph model to evaluate the risk of postoperative constipation in patients with hip fracture according to the influencing factors screened by the statistics, and the model discrimination and accuracy were evaluated.

Sixty-seven of 131 patients had constipation, and the incidence of constipation was 51.2%; there was no obvious difference between constipation group and non constipation group in gender, BMI, smoking, drinking, hypertension, heart disease, diabetes, cerebrovascular disease, operation mode, anesthesia mode, operation duration and intraoperative blood loss (all P>0.05). Compared with the non-constipation group, age, proportion of constipation before surgery, and time in bed after surgery increased, and the proportion of probiotics usage decreased in the constipation group (t=6.816, χ²=35.503, t=15.956, χ²=40.663, all P<0.05). Advanced age, constipation before surgery, prolonged bed rest after surgery, and no probiotics were risk factors for postoperative constipation in patients with hip fracture [odds ratio(OR)=1.251, 22.365, 10.220, 0.030, all P <0.05]. The nomogram model based on age, bed time after operation, probiotics use, and preoperative constipation had a high discrimination and accuracy.

The nomograph model which is based on the age of patients with hip fracture, time in bed after operation, use of probiotics and constipation before operation, has a high predictive value for whether constipation will occure after hip fracture. The nomograph model can provide help for the screening of postoperative constipation in patients with hip fracture.