Background: To explore the effect of delirium on postoperative early prognosis of geriatric patients with hip fracture. Methods: According to whether postoperative delirium (POD) appeared in elderly patients with hip fracture, all cases were divided into two groups: delirium and non-delirium. General parameters, operative parameters, length of stay (LOS), and perioperative complications were recorded. Recurrent fracture, new stroke, and mortality within 1 year postoperatively were followed up and compared between the two groups. Results: Of 358 cases, 55 (15.4%) developed delirium. Compared with the non-delirium group, the delirium group had longer operative times (P=0.031); increased platelet (P=0.002) and C-reactive protein (P<0.001) levels; and reduced hemoglobin (P<0.001), calcium (P=0.040), albumin (P<0.001), prealbumin (P<0.001), and total cholesterol (P=0.019) levels. Complications occurred to some extent in 196 cases (54.7%). In the delirium group, complication rates of pulmonary infection (P=0.005), hypoalbuminemia (P<0.001), electrolyte disorder (P<0.001), dyspepsia (P=0.027), bedsore (P=0.012) and anemia (P=0.007) were higher. In addition, LOS was significantly longer (15.71 ± 4.72 vs 14.00 ± 5.30 days; P=0.026) in the delirium group. Within 1 year postoperatively, 31 individuals (8.7%) had died, 13 were treated for recurrent fracture, and 42 had a new stroke. In the delirium group, mortality within 1 year postoperatively was higher (27.3% vs 5.3%, P<0.001). Conclusions: The morbidity of POD is high in geriatric patients with hip fractures. There was longer surgery delay, higher complication rate, longer LOS, and increased mortality in the delirium group. Early intervention of POD has important clinical significance.
IntroductionMany patients with knee osteoarthritis also suffer from diabetes mellitus and the possibility of deep venous thrombosis (DVT) is increased following unicompartmental knee arthroplasty (UKA). Therefore, we evaluated whether DVT occurrence increased 3 days following operation in diabetic patients undergoing UKA. Materials and methodsThe incidence of deep venous thrombosis between non-diabetic and diabetic patients who underwent UKA in our hospital from August 2018 to January 2020 was compared, and the effect of glycosylated hemoglobin levels on DVT was evaluated. ResultsOf the 84 patients, 25 (29.8%) had diabetes and 59 (70.2%) did not. Within 3 days after operation, DVT occurred in 12 cases (48.0%) in the diabetic group and 8 cases (13.6%) (p < 0.001) in the control group. In logistic regression analysis, the results demonstrated that the risk of deep venous thrombosis in diabetic group was 5.53 times higher compared with non-diabetic group. For every 1 unit increase of glycosylated hemoglobin, the incidence of DVT increased 2.88 times (95% CI: 1.097-7.559, p = 0.032). There was no significant difference in age, sex, body mass index, hypertension, mode of anesthesia, operation time, intraoperative blood loss, tourniquet pressure and time between the two groups. ConclusionThe incidence of DVT in diabetic patients within 3 days after UKA is significantly higher than that in non-diabetic patients. The higher the concentration of glycosylated hemoglobin, the greater the risk of DVT.
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