Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture

Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture

Yi-Hwa Choi,1 Dae-Hwan Kim,2 Tae-Young Kim,2 Tae-Wan Lim,1 Seok-Woo Kim,2 Je-Hyun Yoo2 1Department of Anesthesiology and Pain Medicine, Hallym Sacred Heart Hospital, Hallym University College of Medicine, 2Department of Orthopaedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of...

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Autores principales: Choi YH, Kim DH, Kim TY, Lim T, Kim SW, Yoo JH
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2017
Materias:
Delirium
Elderly patients
Femoral neck fracture
Hemiarthroplasty
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/a1409ca9c7c3420296d2cd6f66b92d4a
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spelling oai:doaj.org-article:a1409ca9c7c3420296d2cd6f66b92d4a2021-12-02T02:14:54ZEarly postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture1178-1998https://doaj.org/article/a1409ca9c7c3420296d2cd6f66b92d4a2017-11-01T00:00:00Zhttps://www.dovepress.com/early-postoperative-delirium-after-hemiarthroplasty-in-elderly-patient-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Yi-Hwa Choi,1 Dae-Hwan Kim,2 Tae-Young Kim,2 Tae-Wan Lim,1 Seok-Woo Kim,2 Je-Hyun Yoo2 1Department of Anesthesiology and Pain Medicine, Hallym Sacred Heart Hospital, Hallym University College of Medicine, 2Department of Orthopaedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of postoperative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture.Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled. Diagnosis of delirium was made by a psychiatrist based on patient status and an objective scoring system. The patients were divided into 2 categories according to the HA onset time (immediate [≤24 h after surgery] vs delayed delirium [>24 h after surgery]) and its incidence, predictors and mortality were evaluated.Results: Postoperative delirium was diagnosed in 110 patients (30.9%) during hospitalization. Immediate and delayed delirium occurred in 59 (53.6%), and 51 (46.4%) patients, respectively. The independent predictors of immediate delirium included age (odds ratio [OR] 1.47, 95% CI 0.98–2.23, p=0.066), and general anesthesia (OR 2.25, 95% CI 1.17–4.43, p=0.015). The independent predictors of delayed delirium were parkinsonism (OR 5.75, 95% CI 1.66–19.96, p=0.006), intensive care unit stay (OR 1.85, 95% CI 0.97–3.56, p=0.064), and higher American Society of Anesthesiologists grade (OR 2.33, 95% CI 0.90–6.07, p=0.083). On Kaplan–Meier survival analysis, the 2-year survival rate was significantly lower in the immediate delirium group than those in the delayed and control groups (71.0% vs 83.6% vs 87.8%, respectively; p=0.031).Conclusion: Immediate and delayed delirium after HA for femoral neck fracture had different predictors and immediate delirium was associated with worse prognosis. Keywords: delirium, elderly patients, femoral neck fracture, hemiarthroplastyChoi YHKim DHKim TYLim TKim SWYoo JHDove Medical PressarticleDeliriumElderly patientsFemoral neck fractureHemiarthroplastyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1835-1842 (2017)
institution DOAJ
collection DOAJ
language EN
topic Delirium
Elderly patients
Femoral neck fracture
Hemiarthroplasty
Geriatrics
RC952-954.6
spellingShingle Delirium
Elderly patients
Femoral neck fracture
Hemiarthroplasty
Geriatrics
RC952-954.6
Choi YH
Kim DH
Kim TY
Lim T
Kim SW
Yoo JH
Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
description Yi-Hwa Choi,1 Dae-Hwan Kim,2 Tae-Young Kim,2 Tae-Wan Lim,1 Seok-Woo Kim,2 Je-Hyun Yoo2 1Department of Anesthesiology and Pain Medicine, Hallym Sacred Heart Hospital, Hallym University College of Medicine, 2Department of Orthopaedic Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea Purpose: Postoperative delirium is a risk factor for worse outcome after hip fracture surgery in elderly patients. Postoperative delirium is associated with anesthesia, postoperative pain, and patient factors. We investigated the incidence, predictors, and prognostic implications of postoperative delirium after hemiarthroplasty (HA) in elderly patients with femoral neck fracture.Patients and methods: A total of 356 consecutive patients aged >70 years who underwent HA for femoral neck fracture were enrolled. Diagnosis of delirium was made by a psychiatrist based on patient status and an objective scoring system. The patients were divided into 2 categories according to the HA onset time (immediate [≤24 h after surgery] vs delayed delirium [>24 h after surgery]) and its incidence, predictors and mortality were evaluated.Results: Postoperative delirium was diagnosed in 110 patients (30.9%) during hospitalization. Immediate and delayed delirium occurred in 59 (53.6%), and 51 (46.4%) patients, respectively. The independent predictors of immediate delirium included age (odds ratio [OR] 1.47, 95% CI 0.98–2.23, p=0.066), and general anesthesia (OR 2.25, 95% CI 1.17–4.43, p=0.015). The independent predictors of delayed delirium were parkinsonism (OR 5.75, 95% CI 1.66–19.96, p=0.006), intensive care unit stay (OR 1.85, 95% CI 0.97–3.56, p=0.064), and higher American Society of Anesthesiologists grade (OR 2.33, 95% CI 0.90–6.07, p=0.083). On Kaplan–Meier survival analysis, the 2-year survival rate was significantly lower in the immediate delirium group than those in the delayed and control groups (71.0% vs 83.6% vs 87.8%, respectively; p=0.031).Conclusion: Immediate and delayed delirium after HA for femoral neck fracture had different predictors and immediate delirium was associated with worse prognosis. Keywords: delirium, elderly patients, femoral neck fracture, hemiarthroplasty
format article
author Choi YH
Kim DH
Kim TY
Lim T
Kim SW
Yoo JH
author_facet Choi YH
Kim DH
Kim TY
Lim T
Kim SW
Yoo JH
author_sort Choi YH
title Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
title_short Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
title_full Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
title_fullStr Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
title_full_unstemmed Early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
title_sort early postoperative delirium after hemiarthroplasty in elderly patients aged over 70 years with displaced femoral neck fracture
publisher Dove Medical Press
publishDate 2017
url https://doaj.org/article/a1409ca9c7c3420296d2cd6f66b92d4a
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