$Dementia and delirium, the outcomes in elderly hip fracture patients$
Código QR

Dementia and delirium, the outcomes in elderly hip fracture patients

Christina A Mosk,1 Marnix Mus,1 Jos PAM Vroemen,1 Tjeerd van der Ploeg,2 Dagmar I Vos,1 Leon HGJ Elmans,3 Lijckle van der Laan1 1Department of Surgery, Amphia Hospital, Breda, 2Department of Public Health, Erasmus MC–University Medical Center, Rotterdam, 3Department of Orthopedic Surgery,...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Mosk CA, Mus M, Vroemen JPAM, van der Ploeg T, Vos DI, Elmans LHGJ, van der Laan L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Hip fracture elderly dementia delirium complications Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/559bae0c2e024750ba5230f265e12d29
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:559bae0c2e024750ba5230f265e12d29
record_format	dspace
spelling	oai:doaj.org-article:559bae0c2e024750ba5230f265e12d292021-12-02T02:52:57ZDementia and delirium, the outcomes in elderly hip fracture patients1178-1998https://doaj.org/article/559bae0c2e024750ba5230f265e12d292017-03-01T00:00:00Zhttps://www.dovepress.com/dementia-and-delirium-the-outcomes-in-elderly-hip-fracture-patients-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Christina A Mosk,1 Marnix Mus,1 Jos PAM Vroemen,1 Tjeerd van der Ploeg,2 Dagmar I Vos,1 Leon HGJ Elmans,3 Lijckle van der Laan1 1Department of Surgery, Amphia Hospital, Breda, 2Department of Public Health, Erasmus MC–University Medical Center, Rotterdam, 3Department of Orthopedic Surgery, Amphia Hospital, Breda, the Netherlands Background: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium.Methods: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc., Verona, WI, USA) was used to assess data between January 2014 and September 2015. All patients presented were aged ≥70 years with a hip fracture, who underwent surgery with osteosynthesis or arthroplasty. Patients were excluded in case of a pathological or a periprosthetic hip fracture, multiple traumatic injuries, and high-energy trauma. Patient and surgical characteristics were documented. Postoperative outcomes were noted. Delirium was screened using Delirium Observation Screening Scale and dementia was assessed from medical notes.Results: Of a total of 566 included patients, 75% were females. The median age was 84 years (interquartile range: 9). Delirium was observed in 35%. Significant risk factors for delirium were a high American Society of Anesthesiology score, delirium in medical history, functional dependency, preoperative institutionalization, low hemoglobin level, and high amount of blood transfusion. Delirium was correlated with a longer hospital stay (P=0.001), increased association with complications (P<0.001), institutionalization (P<0.001), and 6-month mortality (P<0.001). Patients with dementia (N=168) had a higher delirium rate (57.7%, P<0.001) but a shorter hospital stay (P<0.001). There was no significant difference in the 6-month mortality between delirious patients with (34.0%) and without dementia (26.3%).Conclusion: Elderly patients with a hip fracture are vulnerable for delirium, especially when the patient has dementia. Patients who underwent an episode of delirium were at increased risk for adverse outcomes.Keywords: hip fracture, elderly, dementia, delirium, complications, adverse outcomesMosk CAMus MVroemen JPAMvan der Ploeg TVos DIElmans LHGJvan der Laan LDove Medical PressarticleHip fractureelderlydementiadeliriumcomplicationsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 421-430 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hip fracture elderly dementia delirium complications Geriatrics RC952-954.6
spellingShingle	Hip fracture elderly dementia delirium complications Geriatrics RC952-954.6 Mosk CA Mus M Vroemen JPAM van der Ploeg T Vos DI Elmans LHGJ van der Laan L Dementia and delirium, the outcomes in elderly hip fracture patients
description	Christina A Mosk,1 Marnix Mus,1 Jos PAM Vroemen,1 Tjeerd van der Ploeg,2 Dagmar I Vos,1 Leon HGJ Elmans,3 Lijckle van der Laan1 1Department of Surgery, Amphia Hospital, Breda, 2Department of Public Health, Erasmus MC–University Medical Center, Rotterdam, 3Department of Orthopedic Surgery, Amphia Hospital, Breda, the Netherlands Background: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium.Methods: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc., Verona, WI, USA) was used to assess data between January 2014 and September 2015. All patients presented were aged ≥70 years with a hip fracture, who underwent surgery with osteosynthesis or arthroplasty. Patients were excluded in case of a pathological or a periprosthetic hip fracture, multiple traumatic injuries, and high-energy trauma. Patient and surgical characteristics were documented. Postoperative outcomes were noted. Delirium was screened using Delirium Observation Screening Scale and dementia was assessed from medical notes.Results: Of a total of 566 included patients, 75% were females. The median age was 84 years (interquartile range: 9). Delirium was observed in 35%. Significant risk factors for delirium were a high American Society of Anesthesiology score, delirium in medical history, functional dependency, preoperative institutionalization, low hemoglobin level, and high amount of blood transfusion. Delirium was correlated with a longer hospital stay (P=0.001), increased association with complications (P<0.001), institutionalization (P<0.001), and 6-month mortality (P<0.001). Patients with dementia (N=168) had a higher delirium rate (57.7%, P<0.001) but a shorter hospital stay (P<0.001). There was no significant difference in the 6-month mortality between delirious patients with (34.0%) and without dementia (26.3%).Conclusion: Elderly patients with a hip fracture are vulnerable for delirium, especially when the patient has dementia. Patients who underwent an episode of delirium were at increased risk for adverse outcomes.Keywords: hip fracture, elderly, dementia, delirium, complications, adverse outcomes
format	article
author	Mosk CA Mus M Vroemen JPAM van der Ploeg T Vos DI Elmans LHGJ van der Laan L
author_facet	Mosk CA Mus M Vroemen JPAM van der Ploeg T Vos DI Elmans LHGJ van der Laan L
author_sort	Mosk CA
title	Dementia and delirium, the outcomes in elderly hip fracture patients
title_short	Dementia and delirium, the outcomes in elderly hip fracture patients
title_full	Dementia and delirium, the outcomes in elderly hip fracture patients
title_fullStr	Dementia and delirium, the outcomes in elderly hip fracture patients
title_full_unstemmed	Dementia and delirium, the outcomes in elderly hip fracture patients
title_sort	dementia and delirium, the outcomes in elderly hip fracture patients
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/559bae0c2e024750ba5230f265e12d29
work_keys_str_mv	AT moskca dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT musm dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT vroemenjpam dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT vanderploegt dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT vosdi dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT elmanslhgj dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients AT vanderlaanl dementiaanddeliriumtheoutcomesinelderlyhipfracturepatients
_version_	1718402100437712896

Dementia and delirium, the outcomes in elderly hip fracture patients

Ejemplares similares