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  • Oral presentation
  • OP10.03

Delirium after surgery for proximal femoral fractures in the frail elderly patient: Risk factors and clinical outcomes

Appointment

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E 2

Session

Free Oral Presentations 10

Topics

  • Emergency surgery
  • Skeletal trauma and sports medicine

Authors

Eveline de Haan (Rotterdam / NL), Veronique Rijckevorsel (Rotterdam / NL), Pepijn Bod (Rotterdam / NL), Gert Roukema (Rotterdam / NL), Louis de Jong (Rotterdam / NL)

Abstract

Abstract text (incl. references and figure legends)

Introduction

The primary aim of this study was to identify risk factors for delirium after hip fracture surgery. The secondary purpose was to verify peri-operative clinical outcomes, adverse events and mortality rates in delirium patients after hip fracture surgery.

Material & methods

A prospective hip fracture database was used to obtain data. In total 2051 patients older than 70 years undergoing a hip fracture surgery between 01-01-2018 and 01-01-2021 were included. A delirium was diagnosed by geriatrician based on the DSM-V criteria.

Results

The results showed that 16% developed a delirium during hospital admission. Multivariable analysis showed that male gender (OR1.99, p<0,001), age (OR1.06, p<0,001), dementia (OR1.66, p=0,001), Parkinson"s disease (OR2.32, p=0.001), Δhaemoglobin loss (OR1.19, p=0.022), pneumonia (OR3.86, p<0,001), urinary tract infection (UTI) (OR1.97, p=0.001) and wound infection (OR3.02, p=0,007) were significant independent prognostic risk factors for the development of a delirium after hip surgery. The median length in-hospital stay was longer in patients with a delirium (9 days) vs. patients without a delirium (6 days) (p<0,001). The 30-day mortality was 7% (with delirium 16% vs. with no delirium 6% (p<0.001)).

Conclusion

Significant independent prognostic factors associated with delirium after hip surgery were male gender, age, dementia, Parkinson"s disease, Δhaemoglobin loss, pneumonia, UTI and wound infection.

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Funding: nothing to declare

Conflicts of interest/Competing interests: no conflict of interest or competing interests to declare

Ethics approval: The local Medical ethics committee approved the study and the study was registered in the Dutch Trial Register (nr NL 8313)

Consent to participate: Due to the high percentage of cognitive dysfunction in the study population and since there were no changes in usual practice of care, the committee determined that patients" consent to review medical charts was not required.

Consent for publication: see consent to participate

Availability of data and material: on request

Code availability: on request  

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