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2018 ; 4
(ä): 27
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Risk factors for onset of delirium after neck of femur fracture surgery: a
prospective observational study
#MMPMID29995625
Tahir M
; Malik SS
; Ahmed U
; Kozdryk J
; Naqvi SH
; Malik A
SICOT J
2018[]; 4
(ä): 27
PMID29995625
show ga
BACKGROUND: Delirium is a common complication after surgery in the elderly that
leads to increased length of stay and other adverse outcomes. The aim of this
study was to better understand the exact causes of post-operative delirium in
patients undergoing surgery for neck of femur (NOF) fractures. METHODS: We
performed a prospective cohort study of 381 consecutive patients undergoing
surgery for NOF fractures at a single institution. Baseline cognitive status and
risk factors were recorded on admission. Post-operative cognitive status was
assessed at regular intervals until discharge. Binary logistic regression was
performed to identify independent predictors of delirium. RESULTS: Patients who
developed post-operative delirium (n?=?70) were significantly older (average age
83 vs. 78, p?=?0.019) and more likely to be female (79% vs. 67%, p?=?0.062) than
non-affected patients. The presence of delirium was associated with increased
length of stay (13 vs. 10 days, p?=?0.001) and 1-year mortality (25.7% vs. 15%
p?=?0.03). Independent predictors of delirium included age ?65 years (Odds
Ratio?=?5.8), presence of anaemia (OR?=?2.9), hypoxia (OR?=?2.86), cardiac
disease (OR?=?2.8), Chronic Obstructive Pulmonary Disease (OR?=?2.5), new onset
electrolyte imbalance (OR?=?2.2) and renal failure (OR?=?1.9). CONCLUSION:
Overall analysis demonstrated an increased incidence of delirium in older females
with greater comorbid conditions. It was also found to be associated with
increased morbidity and mortality. We recommend clinicians put greater effort
into recognising risk factors of delirium and diagnosing it in a timely manner to
mitigate its effects.