Risk factors for postoperative delirium in hip fractures in the elderly

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

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.

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.

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.