Analysis of risk factors related to perioperative neurocognitive disorders in elderly patients with hip fractures

To explore the risk factors related to perioperative neurocognitive disorders (PND) in elderly patients with hip fractures, with perioperative acute pain management as the core. This study used a retrospective case-control study method. 90 elderly patients who underwent artificial femoral head replacement or total hip replacement surgery in our hospital from 2022 to 2023 were collected, and divided into PND group and non-PND group based on the occurrence of PND. Collected data on 17 factors and conducted univariate and multivariate regression analysis to analyze the risk factors and contribution value of PND in elderly patients with hip fractures. Univariate analysis showed that compared with the non-PND group, patients in the PND group showed a significant increase in age, higher ASA class, longer surgical time, increased number of nerve block cases, increased postoperative 12 h visual analogue scale (VAS) scores, increased postoperative 24 h VAS scores, and increased levels of CRP, PCT, and BL-6 (P < 0.05). Multivariate regression analysis found that the risk factors for PND were postoperative 12 h VAS scores, postoperative 24 h VAS scores, CRP, PCT, and BL-6. The protective factors were ASA class III and ASA class II. The risk factors for PND in elderly patients undergoing hip fracture surgery included postoperative 12 h VAS scores (OR = 3.356), postoperative 24 h VAS scores (OR = 2.311), CRP (OR = 1.058), PCT (OR = 18.661), and BL-6 (OR = 1.061). The protective factors were ASA class III (OR = 0.039) and ASA class II (OR = 0.016).