Risk factors for postoperative delirium in hip fractures in the elderly.

PURPOSE: To identify the risk factors for postoperative delirium (POD) in elderly patients with hip fracture and to examine the interrelationships among these factors.

METHODS

Data of 210 elderly patients (≥65 years) who underwent surgical treatment for hip fractures from Jan 2023 to Dec 2023 were retrospectively analyzed. The patients were divided into the POD group and non-POD group based on whether they developed POD. The univariate analysis and binary multiple logistic regression were performed to determine the pre-, intra- and postoperative risk factors related to POD. The study was reported following the STROBE checklist.

RESULTS

Among 210 patients, 26 were diagnosed with POD, representing 12.4 % of the cohort. The average POD time was 1.62 ± 0.75 days postoperatively. The incidence of POD was highest on the first day after surgery. The univariate comparison showed that the age, atrial fibrillation ratio, stroke history ratio, preoperative CAM-CR score, postoperative transferred to ICU ratio was higher in POD group compared with non-POD group. The general anaesthesia ratio in non-POD group was higher than POD group. The multivariate logistic regression showed that preoperative CAM-CR ≥ 15 score, age ≥80 years, atrial fibrillation, stroke history, fracture-surgery interval ≥7 days and postoperative transferred to ICU were independent risk factors of POD.

CONCLUSION

The potential risk factors of POD for hip fractures in the elderly include age≥80 years, preoperative CAM-CR ≥ 15 score, atrial fibrillation, stroke history, fracture-surgery interval ≥7 days and postoperative transferred to ICU.