Impact of Delirium on Short-term Prognosis in Geriatric Patients with Hip Fracture

Abstract

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.