Type 2 diabetes mellitus significantly increased the risk of postoperative delirium (OR 3.654, p=0.001), while higher preoperative fasting blood glucose and good stair climbing capacity were protective.
Observational (n=309)
No
Are preoperative glycemic control factors and pre-injury physical performance associated with postoperative delirium in older hip fracture surgery patients?
In older patients undergoing hip fracture surgery, T2DM increases the risk of postoperative delirium, while higher preoperative fasting blood glucose and better pre-injury stair climbing capacity are protective.
Odds Ratio: 3.654
p-value: p=0.001
(1) Background: Previous evidence demonstrates that tight glycemic control and good physical function could reduce the risk of delirium. This study aimed to investigate whether the occurrence of postoperative delirium (POD) in older hip fracture surgery patients is associated with preoperative glycemic control factors or pre-injury physical performance. (2) Methods: Three-hundred and nine individuals aged over 65 years and scheduled for hip fracture surgery were included at a single center. Glycemic control factors and pre-injury physical performance were assessed preoperatively. The presence of delirium was assessed using the Confusion Assessment Method on postoperative hospitalization days. Univariate and multivariable logistic regression models and a risk prediction model of POD were established. (3) Results: Among the 309 patients, 52 (16.83%) experienced POD during the hospital stay. The numbers of pre-injury physical performance and type 2 diabetes mellitus (T2DM) patients were significantly different in the POD and non-POD groups. The multivariable model showed that development of delirium was significantly explained by preoperative fasting blood glucose (FBG) (OR 0.804, p = 0.004), stair climbing (OR 0.709, p = 0.003), T2DM (odds ratio (OR) 3.654, p = 0.001), and age-adjusted Charlson comorbidity index (ACCI) (OR 1.270, p = 0.038). The area under the receiver operating characteristic curve (AUROC) of the risk prediction model including those covariates was 0.770. (4) Conclusions: More older T2DM patients develop POD after hip fracture surgery than patients without T2DM. A simple assessment of preoperative FBG and pre-injury stair climbing capacity may identify those at high risk for the development of POD. Higher preoperative FBG and good pre-injury stair climbing capacity are protective factors for POD.
Liu et al. (Wed,) conducted a observational in Hip fracture (n=309). Type 2 diabetes mellitus, preoperative fasting blood glucose, and pre-injury stair climbing capacity vs. Absence of T2DM, lower fasting blood glucose, and poor stair climbing capacity was evaluated on Postoperative delirium (POD) (OR 3.654, p=0.001). Type 2 diabetes mellitus significantly increased the risk of postoperative delirium (OR 3.654, p=0.001), while higher preoperative fasting blood glucose and good stair climbing capacity were protective.