Risk factors associated with postoperative delirium in elderly patients undergoing hip surgery

Xiao-Hong Liu; Qing-Fu Zhang; Ying Liu; Qing-Wang Lu; Jian-Hua Wu; Xiao-Hua Gao; Zhi-Yuan Chen

doi:10.3389/fpsyt.2023.1288117

Risk factors associated with postoperative delirium in elderly patients undergoing hip surgery

Front Psychiatry. 2023 Oct 19:14:1288117. doi: 10.3389/fpsyt.2023.1288117. eCollection 2023.

Authors

Xiao-Hong Liu^{1

2}, Qing-Fu Zhang³, Ying Liu¹, Qing-Wang Lu², Jian-Hua Wu¹, Xiao-Hua Gao¹, Zhi-Yuan Chen¹

Affiliations

¹ Department of Anesthesiology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
² Department of Anesthesiology, Jinjiang Municipal Hospital (Shanghai Sixth People's Hospital Fujian Campus), Jinjiang, China.
³ Department of Anesthesiology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China.

Abstract

Objective: We retrospectively analyzed the occurrence of postoperative delirium following hip surgery and the associated risk factors. The aim was to establish a clinical foundation for preventing postoperative delirium after hip surgery.

Methods: We retrospectively selected elderly patients who had hip surgery at our hospital between January 2022 and August 2022. We included patients who experienced delirium in the observation group and those who did not encounter delirium in the control group. We then proceeded to compare various indicators among these two groups of patients.

Results: We analyzed a total of 97 cases of hip surgery, and among them, 32 cases experienced postoperative delirium, resulting in an incidence rate of 32.9%. Various factors were found to be linked to the development of postoperative delirium, including age, height, gender (male), preoperative erythrocyte sedimentation rate (ESR), postoperative ESR, preoperative lactate levels, pain scores on the first day after surgery, type of surgical procedure, and the occurrence of delirium in the post-anesthesia care unit (PACU delirium). Additionally, it was observed that 75% of patients who had PACU delirium also experienced postoperative delirium.

Conclusion: Postoperative delirium in patients who have hip surgery had an incidence rate of 32.9%. This phenomenon is linked to various factors that pose a risk, such as the patient age, height, gender, preoperative ESR levels, postoperative ESR levels, preoperative lactate levels, pain scores on the day following surgery, and the specific surgical procedure performed. The likelihood of experiencing delirium increases by 12% for every additional 10 years in patient age. Additionally, the occurrence of delirium in the PACU is a strong indicator of the likelihood of experiencing postoperative delirium.

Keywords: PACU; elderly retrospective study; hip surgery; postoperative delirium; prediction.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by the Jinjiang City Hospital Youth Project (2022QN04) and Guiding (key) project of social development in Fujian Province (2022Y0028).