$Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes$
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Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes

Louis de Jong,1 Veronique AJIM van Rijckevorsel,1 Jelle W Raats,1 Taco MAL Klem,2 Tjallingius M Kuijper,3 Gert R Roukema11Surgery Department, Maasstad Hospital, 3079 DZ Rotterdam, the Netherlands; 2Surgery Department, Franciscus Hospital, 3045 PM Rotterdam, the Netherlands; 3Science Board, Maasstad...

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Autores principales:	de Jong L, van Rijckevorsel VAJIM, Raats JW, Klem TMAL, Kuijper TM, Roukema GR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Delirium hip fracture femoral neck fracture mortality risk and prognostic factors Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/a310f3314ea742c4a151f9483dcf16c9
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spelling	oai:doaj.org-article:a310f3314ea742c4a151f9483dcf16c92021-12-02T01:56:38ZDelirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes1178-1998https://doaj.org/article/a310f3314ea742c4a151f9483dcf16c92019-02-01T00:00:00Zhttps://www.dovepress.com/delirium-after-hip-hemiarthroplasty-for-proximal-femoral-fractures-in--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Louis de Jong,1 Veronique AJIM van Rijckevorsel,1 Jelle W Raats,1 Taco MAL Klem,2 Tjallingius M Kuijper,3 Gert R Roukema11Surgery Department, Maasstad Hospital, 3079 DZ Rotterdam, the Netherlands; 2Surgery Department, Franciscus Hospital, 3045 PM Rotterdam, the Netherlands; 3Science Board, Maasstad Hospital, 3079 DZ Rotterdam, the NetherlandsBackground: The primary aim of the present study was to verify the potential risk factors for developing a delirium after hip fracture surgery. The secondary aim of this study was to examine the related clinical outcomes after a delirium developed post-hip fracture surgery.Patients and methods: Data were extracted from a prospective hip fracture database and completed by retrospective review of the hospital records. A total of 463 patients undergoing hip fracture (hip hemiarthroplasty) surgery in a level II trauma teaching hospital between January 2011 and May 2016 were included. Delirium was measured using the Delirium Observation Screening Scale, the confusion assessment method, and an observatory judgment by geriatric medicine specialists.Results: The results showed that 26% of the patients (n=121) developed a delirium during hospital stay with a median duration during admission of 5 days (IQR 3–7). The multivariable model showed that the development of delirium was significantly explained by dementia (OR 2.75, P=0.001), age (OR 1.06, P=0.005), and an infection during admission (pneumonia, deep surgical site infection, or urinary tract infection) (OR 1.23, P=0.046). After 1 year of follow-up, patients who developed delirium after hip fracture surgery were significantly more discharged to (semi-independent) nursing homes (P<0.001) and had a significantly higher mortality rate (P<0.001) compared to patients without delirium after hip fracture surgery.Conclusions: The results showed that 26% of the patients undergoing hip fracture surgery developed a delirium. The risk factors including age, dementia, and infection during admission significantly predicted the development of the delirium. No association was confirmed between delirium and time of admission or time to surgery. The development of delirium after hip fracture surgery was subsequently found to be a significant predictor of admission to a nursing home and mortality after 1 year.Keywords: delirium, hip fracture, femoral neck fracture, mortality, risk and prognostic factors, hemi athroplasty, fragilede Jong Lvan Rijckevorsel VAJIMRaats JWKlem TMALKuijper TMRoukema GRDove Medical PressarticleDeliriumhip fracturefemoral neck fracturemortalityrisk and prognostic factorsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 427-435 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Delirium hip fracture femoral neck fracture mortality risk and prognostic factors Geriatrics RC952-954.6
spellingShingle	Delirium hip fracture femoral neck fracture mortality risk and prognostic factors Geriatrics RC952-954.6 de Jong L van Rijckevorsel VAJIM Raats JW Klem TMAL Kuijper TM Roukema GR Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
description	Louis de Jong,1 Veronique AJIM van Rijckevorsel,1 Jelle W Raats,1 Taco MAL Klem,2 Tjallingius M Kuijper,3 Gert R Roukema11Surgery Department, Maasstad Hospital, 3079 DZ Rotterdam, the Netherlands; 2Surgery Department, Franciscus Hospital, 3045 PM Rotterdam, the Netherlands; 3Science Board, Maasstad Hospital, 3079 DZ Rotterdam, the NetherlandsBackground: The primary aim of the present study was to verify the potential risk factors for developing a delirium after hip fracture surgery. The secondary aim of this study was to examine the related clinical outcomes after a delirium developed post-hip fracture surgery.Patients and methods: Data were extracted from a prospective hip fracture database and completed by retrospective review of the hospital records. A total of 463 patients undergoing hip fracture (hip hemiarthroplasty) surgery in a level II trauma teaching hospital between January 2011 and May 2016 were included. Delirium was measured using the Delirium Observation Screening Scale, the confusion assessment method, and an observatory judgment by geriatric medicine specialists.Results: The results showed that 26% of the patients (n=121) developed a delirium during hospital stay with a median duration during admission of 5 days (IQR 3–7). The multivariable model showed that the development of delirium was significantly explained by dementia (OR 2.75, P=0.001), age (OR 1.06, P=0.005), and an infection during admission (pneumonia, deep surgical site infection, or urinary tract infection) (OR 1.23, P=0.046). After 1 year of follow-up, patients who developed delirium after hip fracture surgery were significantly more discharged to (semi-independent) nursing homes (P<0.001) and had a significantly higher mortality rate (P<0.001) compared to patients without delirium after hip fracture surgery.Conclusions: The results showed that 26% of the patients undergoing hip fracture surgery developed a delirium. The risk factors including age, dementia, and infection during admission significantly predicted the development of the delirium. No association was confirmed between delirium and time of admission or time to surgery. The development of delirium after hip fracture surgery was subsequently found to be a significant predictor of admission to a nursing home and mortality after 1 year.Keywords: delirium, hip fracture, femoral neck fracture, mortality, risk and prognostic factors, hemi athroplasty, fragile
format	article
author	de Jong L van Rijckevorsel VAJIM Raats JW Klem TMAL Kuijper TM Roukema GR
author_facet	de Jong L van Rijckevorsel VAJIM Raats JW Klem TMAL Kuijper TM Roukema GR
author_sort	de Jong L
title	Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
title_short	Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
title_full	Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
title_fullStr	Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
title_full_unstemmed	Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
title_sort	delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/a310f3314ea742c4a151f9483dcf16c9
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Delirium after hip hemiarthroplasty for proximal femoral fractures in elderly patients: risk factors and clinical outcomes

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