Predictors of Delirium in Octogenarian Patients Hospitalized for a Hip Fracture

Carmona, María Plaza; Hernández, Carmen Requena; Jiménez-Mola, Sonia

doi:10.3390/ijerph17207467

Cited by 5 publications

(5 citation statements)

References 26 publications

(39 reference statements)

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“…Hip fracture surgery is traumatic and usually takes a long time, thus the postoperative stress response is obvious. It disrupts the hypothalamus–pituitary–thyroid axis of the patient and affects thyroid function [ 44 ]. Thyroid hormone is an essential substance for maintaining the normal function of the central nervous system and is closely associated with human mental activity [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with post-operative delirium in hip fracture patients: what should we care

et al. 2022

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Background The postoperative delirium is a common yet serious complication in elderly patients with hip fracture. We aimed to evaluate the potential risk factors of delirium in patients with hip fracture, to provide reliable evidence to the clinical management of hip fracture. Methods This study was a retrospective design. Elderly patients who underwent hip fracture surgery in our hospital from June 1, 2019 to December 30, 2020 were selected. The characteristics and treatment data of delirium and no delirium patients were collected and compared. Multivariate logistic regression analysis was performed to analyze the influencing factors affecting postoperative delirium in elderly patients with hip fracture. Results A total of 245 patients with hip fracture were included, the incidence of postoperative delirium in patients with hip fracture was 13.06%. There were significant differences in the age, BMI, history of delirium, estimated blood loss and duration of surgery (all p < 0.05). There were significant differences in the albumin and TSH between delirium and no delirium group (all p < 0.05), Logistics analyses indicated that age ≥ 75 years (OR 3.112, 95% CI 1.527–5.742), BMI ≥ 24 kg/m2 (OR 2.127, 95% CI 1.144–3.598), history of delirium (OR 1.754, 95% CI 1.173–2.347), estimated blood loss ≥ 400 mL (OR 1.698, 95% CI 1.427–1.946), duration of surgery ≥ 120 min (OR 2.138, 95% CI 1.126–3.085), preoperative albumin ≤ 40 g/L (OR 1.845, 95% CI 1.102–2.835) and TSH ≤ 2 mU/L (OR 2.226, 95% CI 1.329–4.011) were the independent risk factors of postoperative delirium in patients with hip fracture(all p < 0.05). Conclusions Postoperative delirium is very common in elderly patients with hip fracture, and it is associated with many risk factors, clinical preventions targeted on those risk factors are needed to reduce the postoperative delirium.

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Section: Discussionmentioning

confidence: 99%

Factors associated with post-operative delirium in hip fracture patients: what should we care

et al. 2022

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“…Third, patients with dementia before injury were excluded to remove the effect of dementia on delirium. There are many risk factors for postoperative delirium 16,17 , including advanced age, dementia, anemia, dehydration, pain, anesthesia and other factors. However, this is the first study to examine risk factors associated with postoperative delirium among nonagenarians with hip fracture.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and prognosis of postoperative delirium in nonagenarians with hip fracture

Zhao

Sun²,

Zhang³

et al. 2023

Sci Rep

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Hip fractures in nonagenarians is one of the great challenges for patients of this age, the family and the larger society. The purpose of this study was to investigate the risk factors and prognosis of postoperative delirium in nonagenarians with hip fracture. 199 Eligible patients were enrolled. Confusion Assessment Method (CAM) were used to identify the delirium. Logistic regressions were used to investigate the effect of 18 pre-existing conditions on postoperative delirium. Prognosis of postoperative delirium in nonagenarians with hip fracture were also be evaluated. The results indicated the following: (1) the prevalence of postoperative delirium among nonagenarians with hip fracture was 28.1% (56 of 199); (2) coexisting disease ≥ 4 (OR = 5.355, 95% CI = 1.394–9.074, P = 0.007), longer admission to operating time (OR = 1.514, 95% CI = 1.247–1.837, P = 0.000), and general anesthesia (OR = 2.086, 95% CI = 1.804–7.968, P = 0.032) were independent risk factors for postoperative delirium in nonagenarians with hip fracture; (3) nonagenarians with postoperative delirium had a predominantly high burden of perioperative complications, long length of stay, and postoperative mortality at 30 days follow-up and 1 year follow-up than the patients without postoperative delirium. The results could enable clinicians to improve outcome after operation in nonagenarians with hip fracture.

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“…Hip fracture surgery is traumatic and usually takes a long time, thus the postoperative stress response is obvious. It disrupts the hypothalamus-pituitary-thyroid axis of the patient and affects thyroid function [41]. Thyroid hormone is an essential substance for maintaining the normal function of the central nervous system and is closely related to human mental activity [42].…”

Section: Discussionmentioning

confidence: 99%

The Influencing Factors of Postoperative Delirium in Elderly Hip Fracture Patients: What Should Treatment Focus On

Yan

Yang

Niu

et al. 2021

Preprint

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Background: The postoperative delirium is a common yet serious complication in elderly patients with hip fracture, it’s necessary to evaluate the potential risk factors of delirium in patients with hip fracture, to provide reliable evidence to the clinical management of hip fracture.Methods: Elderly patients who underwent hip fracture surgery in our hospital from June 1, 2019 to May 31, 2021 were selected. The characteristics and treatment data of delirium and no delirium patients were collected and compared. Multivariate logistic regression analysis was conducted to analyze the influencing factors affecting postoperative delirium in elderly patients with hip fracture.Results: A total of 245 patients with hip fracture were included, the incidence of postoperative delirium in patients with hip fracture was 13.06%. There were significant differences in the age, BMI, history of delirium, estimated blood loss and duration of surgery (all p<0.05). There were significant differences in the albumin and TSH between delirium and no delirium group(all p<0.05), Logistics analyses indicated that ge≥75y(OR3.112,95%CI1.527~5.742), BMI ≥24 kg/m2(OR2.127,95%CI1.144~3.598), history of delirium(OR1.754,95%CI1.173~2.347), estimated blood loss≥400ml(OR1.698,95%CI1.427~1.946), duration of surgery≥120min(OR2.138,95%CI1.126~3.085), preoperative albumin≤40g/L(OR1.845,95%CI1.102~2.835) and TSH≤2mU/L(OR2.226, 95%CI1.329~4.011) were the independent risk factors of postoperative delirium in patients with hip fracture(all p<0.05).Conclusions: Postoperative delirium is very common in elderly patients with hip fracture, and it was associated with many risk factors, clinical preventions targeted on those risk factors are needed to reduce the postoperative delirium.

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Predictors of Delirium in Octogenarian Patients Hospitalized for a Hip Fracture

Cited by 5 publications

References 26 publications

Factors associated with post-operative delirium in hip fracture patients: what should we care

Factors associated with post-operative delirium in hip fracture patients: what should we care

Risk factors and prognosis of postoperative delirium in nonagenarians with hip fracture

The Influencing Factors of Postoperative Delirium in Elderly Hip Fracture Patients: What Should Treatment Focus On

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