Key result
The overall incidence of post-operative delirium in elderly patients following hip or femur surgery was 40%, with age >70 years, diabetes, general anesthesia, and prolonged surgery identified as significant risk factors.
Why the study?
Postoperative delirium is a common complication in elderly patients undergoing hip and femur surgery that impairs quality of life and prolongs hospital stay, prompting the evaluation of its incidence and associated risk factors.
What is the incidence and what are the risk factors for post-operative delirium in patients >60 years of age undergoing hip/femur surgery?
Observational (n=145)
No
What is the incidence and what are the risk factors for post-operative delirium in patients >60 years of age undergoing hip/femur surgery?
Post-operative delirium is highly prevalent (40%) in elderly patients undergoing hip/femur surgery, with risk factors including age >70, diabetes, electrolyte imbalances, general anesthesia, prolonged surgery, and severe postoperative pain.
High incidence warrants perioperative vigilance in elderly hip surgery patients; leaves open optimal prevention strategies for prospective trials.
Introduction: Hip fracture represents around 1/4 of the geriatric fractures. Over 90% of hip and femur fracture patients are older than 65 years and have pre-existing medical co-morbidities. Postoperative Delirium (POD) is one of the common complications in elders (incidence 5.1%-52.5%) affecting quality of life and may prolong hospital stay. Oh YK et al investigated incidence and risk factors for POD in geriatric patients and assessed delirium using Confusion Assessment Method and Mini Mental State examination. Methods: This was a prospective study design; to evaluate preoperative and intra-operative risk factors for delirium in 145 elder patients (age > 60yrs) following elective hip/femur surgery in tertiary care hospital, primarily focusing on incidence of POD and investigated independent association of risk factors with POD. Confusion Assessment Method was used for assessing POD.Results: The incidence of POD due to preoperative, intra-operative and postoperative risk factors was 26, 25.28 and 48.5 respectively. Conclusion: The incidence of delirium increases post operatively, the incidence being 40 in our study. Age > 70years, abnormal serum sodium and potassium and diabetes mellitus were found as preoperative risk factors; general anesthesia and increased duration of surgery for intra-operative risk factors; VAS score >6 and analgesic usage for postoperative risk factors for development of POD. We suggest that Confusion Assessment Method can be used for assessing POD in elder patients pre and postoperatively.
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Gaude et al. (2023) conducted an observational in Post-operative delirium following hip/femur surgery (n=145). Risk factors for post-operative delirium (e.g., age >70, diabetes, general anesthesia, prolonged surgery) vs. Patients without these risk factors was evaluated on Incidence of post-operative delirium (POD). The overall incidence of post-operative delirium in elderly patients following hip or femur surgery was 40%, with age >70 years, diabetes, general anesthesia, and prolonged surgery identified as significant risk factors.
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