Are elderly patients undergoing blood transfusion during hip fracture surgery at risk of postoperative delirium: a...

Delirium is common following hip fracture surgery. Red blood cell transfusion (RBCT), which is frequently needed in this population, has been inconsistently associated with incident delirium in previous studies. This study aims to investigate whether RBCT in patients undergoing hip fracture surgery is associated with increased risk of post-operative delirium, and to identify potential risk factors that might influence this association.

We conducted a retrospective observational study of all hip fracture patients who underwent surgery between November 1 2020 and February 28 2022. Delirium was diagnosed based on DSM V criteria, and assessed daily. The need of perioperative RBCT, and the number of units transfused, were recorded.

A total of 364 participants with a mean age of 84 years were included. Delirium was recorded in 49 (14%) patients, while 88 (24%) required RBCT. In logistic regression, RBCT was associated with delirium (OR = 3.88, 95% CI = 1.23-12.24), after adjusting. An increasing number of RB units transfused was associated with increased probability of delirium (P for linear trend = .013).

Clinicians should carefully consider the indications for RBCT in hip fracture patients. Further studies are needed to confirm these results, and to investigate the potential mechanisms underlying this association.