Is delirium associated with negative outcomes in older patients with hip fracture: analysis of the 4904 patients 2017-2018 from the Australian and New Zealand hip fracture registry

Tarandeep Oberai; Richard Woodman; Kate Laver; Maria Crotty; Gino Kerkhoffs; Ruurd Jaarsma

doi:10.1111/ans.17421

Is delirium associated with negative outcomes in older patients with hip fracture: analysis of the 4904 patients 2017-2018 from the Australian and New Zealand hip fracture registry

ANZ J Surg. 2022 Jan;92(1-2):200-205. doi: 10.1111/ans.17421. Epub 2021 Dec 13.

Authors

Tarandeep Oberai¹, Richard Woodman², Kate Laver³, Maria Crotty³, Gino Kerkhoffs⁴, Ruurd Jaarsma⁵

Affiliations

¹ Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia.
² Department of Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
³ Department of Rehabilitation, Aged and Extended Aged Care, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
⁴ Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, South Australia, Australia.

PMID: 34904334
DOI: 10.1111/ans.17421

Abstract

Aim: To determine associations between delirium and health outcomes using the Australia and New Zealand population-based hip fracture patient registry (ANZHFR).

Methods: We performed a retrospective cohort study using data from the ANZHFR among hip-fracture surgery patients admitted to and discharged from hospital between 1 January 2017 and 31 December 2018.

Results: Of the 4904 patients with complete data and included in the analysis, 1789 (36.5%) experienced delirium during their hospital stay. Patients with delirium also had a higher rate of in-hospital mortality (adjusted HR = 1.76; 95% CI = 1.24, 2.49; P < 0.001), a higher rate of long-term mortality (adjusted HR = 1.30; 95% CI = 1.15, 1.48; P < 0.001) and a higher odds of discharge to an aged care facility (adjusted OR = 1.24; 95% CI = 1.04, 1.48; P = 0.019).

Conclusion: A high rate of postoperative delirium exists among Australian and New Zealand hip fracture patients. Rates of hospital mortality, length of hospital stay and discharge to residential aged care are considerably worse in these patients.

Keywords: delirium; hip fracture; outcomes.

MeSH terms

Aged
Australia / epidemiology
Delirium* / epidemiology
Delirium* / etiology
Hip Fractures* / complications
Hip Fractures* / epidemiology
Hip Fractures* / surgery
Humans
Length of Stay
New Zealand / epidemiology
Registries
Retrospective Studies