Delirium after Hemiarthroplasty for Neglected Hip Fracture

Hemiarthroplasty of hip joint is a frequently performed procedure in geriatric patients, especially in cases of trauma. Several risk factors are associated with this surgery, including postoperative delirium, which has been linked to poorer functional recovery, longer hospital stays, and higher short- and long-term mortality rates. The present study aimed to compare the rates and risk factors of postoperative delirium and its correlation with neglected cases in geriatric patients.

This retrospective study was performed at Surabaya Orthopedic and Traumatology Hospital, using a manual medical record database ranging from 2019 to 2023. The study focused on geriatric patients who underwent hemiarthroplasty for hip fracture. Demographic, preoperative, and procedural data were collected and analyzed, followed by a review of postoperative outcomes.

Out of 219 patients who underwent hip fracture surgery, 23 were neglected cases while 29 cases developed postoperative delirium. Statistical analysis showed no correlation between the neglected cases and the increased incidence of delirium. Several independent risk factors were identified for postoperative delirium, such as age ≥75 years (odds ratio [OR]=7.766, 95% confidence interval [CI]=1.921-31.393), history of dementia (OR=6.768, 95% CI=1.793-25.555), use of general anesthesia (OR=11.600, 95% CI=1.896-70.972), American Society of Anesthesiologists class 3 (OR=3.245, 95% CI=1.215-8.664), and obesity (OR=9.911, 95% CI=2.009-48.947) (all P<0.05).

Patients with neglected hip fractures who underwent hemiarthroplasty did not show higher incidence of postoperative delirium. The risk factors found in this study can be used to determine whether neglected or non-neglected patients are at high risk of postoperative delirium.