Postoperative Delirium After Hip Fracture

A hip fracture is sustained by 250,000 Americans every year1, and that number is expected to double by 20402. The most frequent complication associated with hip fracture in elderly patients is postoperative delirium3, with a prevalence ranging between 5% and 61%, depending on the patient population1,3-8. Delirium is often undetected, misdiagnosed, or undertreated9-11. However, this condition has severe consequences for the patient4,5,11. The focus of this article is to provide an overview of current knowledge regarding the outcomes, pathogenesis, diagnosis, prevention, and treatment of postoperative delirium in elderly patients treated for a hip fracture. For the purposes of this article, delirium and acute confusional states are synonymous. Delirium consists of a “disturbance of consciousness.... with reduced ability to focus, sustain, or shift attention.” There is also “a change in cognition... or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.”12 The diagnostic criteria …