The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model.

OBJECTIVE

This study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors.

METHODS

This retrospective observational study prospectively included elderly patients with hip fractures who were admitted to the Trauma Department of our hospital from November 2024 to May 2025, managed under the Unaccompanied-Care nursing model, and underwent surgical treatment. We retrospectively analyzed the patients' baseline data, blood indicators, and surgery-related data for data analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with delirium in the perioperative period.

RESULTS

A total of 138 patients were included, of whom 35 (25.36%) developed delirium. The incidence of delirium was 2.17% (3 cases) preoperatively, 6.52% (9 cases) within 6 h postoperatively, 10.14% (14 cases) within 1 day postoperatively, 4.35% (6 cases) on postoperative day 2, and 2.17% (3 cases) on postoperative day 3. Multivariate analysis showed that mild visual impairment (OR = 15.74, 95% CI: 2.53-97.29, p = 0.003), severe visual impairment (OR = 9.68, 95% CI: 5.20-18.30, p = 0.002); mild hearing impairment (OR = 7.09, 95% CI: 1.23-40.74, p = 0.028), moderate hearing impairment (OR = 6.43, 95% CI: 1.80-51.41, p = 0.031), severe hearing impairment (OR = 16.59, 95% CI: 1.76-156.61, p = 0.014), and hemoglobin (OR = 1.95, 95% CI: 1.91-5.99, p = 0.037) were independent risk factors for delirium.

CONCLUSION

Although the Unaccompanied-Care model shows specific effects in the nursing of elderly patients with hip fractures, the incidence of delirium remains high. Sensory dysfunction and low hemoglobin levels are important risk factors for delirium.