Effects of Peri-Operative Glucocorticoids in Hip Fracture Patients on Post-Operative Outcomes: Systematic Review...

Area of Science:

• Geriatric Medicine
• Anesthesiology
• Pharmacology

Background:

• Elderly hip fracture patients face high risks of post-operative delirium due to frailty and comorbidities.
• Post-operative delirium leads to prolonged recovery, functional decline, increased mortality, and higher healthcare costs.
• Peri-operative glucocorticoids may mitigate surgical inflammation, potentially reducing delirium and adverse outcomes.

Purpose of the Study:

• To systematically review the effects of peri-operative glucocorticoids on post-operative delirium in adults undergoing hip fracture surgery.
• To evaluate associated benefits and harms of peri-operative glucocorticoid use in this patient group.

Main Methods:

• Systematic review following Cochrane methodology and PRISMA guidelines.
• Inclusion of randomized controlled trials and observational studies comparing peri-operative glucocorticoids with placebo or no treatment.
• Primary outcome: post-operative delirium incidence; secondary outcomes: delirium severity, pain, length of stay, mortality, and adverse events.

Main Results:

• Awaiting synthesis of evidence from included studies.
• Meta-analysis will be performed where appropriate to pool data.
• Risk of bias, quality of evidence, and certainty of evidence will be assessed using validated tools (e.g., GRADE).

Conclusions:

• This review will synthesize current evidence on the efficacy and safety of peri-operative glucocorticoids for hip fracture surgery.
• Findings aim to inform clinical practice and guide future research for elderly patients at risk of delirium.
• Focus on reducing post-operative delirium in a vulnerable patient population.