Key result
Surgery for femoral neck fractures was associated with a significant decrease in cognitive function in 14.8% of elderly patients 2 days post-surgery and 11.1% at 7 days.
Why the study?
Does hip surgery cause perioperative cognitive decline in elderly patients with femoral neck fractures?
Cohort (n=27)
Does hip surgery cause perioperative cognitive decline in elderly patients with femoral neck fractures?
In elderly patients with femoral neck fractures, the surgical procedure itself appears to have a stronger impact on cognitive decline than the environmental changes associated with hospital admission.
Cognitive decline after hip fracture surgery warrants monitoring in elderly patients; leaves open whether surgery or admission drives the effect.
To test the hypothesis that elderly patients who have surgery for femoral neck fractures may have delirium not only after surgery but before surgery, we prospectively investigated the perioperative temporal profile of cognitive function in such patients. We performed the Abbreviated Mental Test (AMT) six times in each patient (on the day of admission, 3 days after admission, on the day before surgery, 2 days after surgery, 7 days after surgery, and on the day of discharge). Patients were given no premedication and were anesthetized with spinal anesthesia using 0.2% hypobaric tetracaine. Of the 68 patients who were admitted because of a diagnosis of fractured neck of the femur and were scheduled to have surgery, 27 patients were subjected to analysis. Four and three patients showed a significant decrease (3 or more points) in AMT score 2 and 7 days after surgery, respectively. We conclude that surgery may have a stronger impact on cognitive function than environmental change shortly after admission in elderly patients with femoral neck fractures.
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Sato et al. (2000) conducted a cohort in Femoral neck fractures (n=27). Surgery for femoral neck fractures vs. Pre-surgery baseline was evaluated on Significant decrease (3 or more points) in Abbreviated Mental Test (AMT) score 2 days after surgery. Surgery for femoral neck fractures was associated with a significant decrease in cognitive function in 14.8% of elderly patients 2 days post-surgery and 11.1% at 7 days.
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