Risk factors for postoperative delirium in elderly patients after total hip arthroplasty

doi:10.3969/j.issn.2095-4344.1343

Abstract

Abstract:

BACKGROUND: Delirium is easy to occur in elderly patients after total hip arthroplasty, so it is necessary to identify the risk factors of postoperative delirium.

OBJECTIVE: To investigate the risk factors of postoperative delirium in elderly patients after total hip arthroplasty.

METHODS: Data of patients over 60 years old who underwent total hip arthroplasty in the Third Hospital of Mianyang from May 2016 to December 2018 were retrospectively analyzed. Perioperative data were collected. According to the presence and absence of delirium after operation, the patients were divided into non-delirium group and delirium group. The risk factors of postoperative delirium were analyzed.

RESULTS AND CONCLUSION: (1) The incidence of delirium was 26% (96 cases) after total hip arthroplasty in 365 patients. (2) Univariate analysis showed that age, sex, coronary heart disease, chronic obstructive pulmonary disease, type of disease, cognitive impairment, sleep disorder, anxiety, American Society of Anesthesiologists score, nutritional impairment, weak GFI index, leukocyte count before and after operation, erythrocyte specific volume after operation, hemoglobin level after operation, C-reactive protein after operation and intraoperative blood loss were significantly different between the two groups (P < 0.05). (3) Multivariate Logistic regression analysis showed that age (OR=1.19, 95%CI: 1.12-1.25), American Society of Anesthesiologists score (OR=8.03, 95%CI: 4.54-14.21), GFI score (OR=2.14, 95%CI: 1.78-2.57), postoperative C-reactive protein (OR=1.07, 95%CI: 1.05-1.09), combined with chronic obstructive pulmonary disease (OR=0.43, 95%CI: 0.26-0.69), total hip arthroplasty for femoral neck fracture (OR=3.67, 95%CI: 2.23-6.13) were high risk factors for postoperative delirium after total hip arthroplasty in the elderly (P < 0.05). (4) ROC curve analysis displayed that when age > 71 years old, American Society of Anesthesiologists score > 2, weakness GFI score ≥ 5, and C-reactive protein > 47 mmol/L, all of them had good specificity and sensitivity, which has certain clinical value in predicting postoperative delirium.

Key words: total hip arthroplasty, postoperative delirium, frailty, osteonecrosis of femoral head, anxiety, depression, American Society of Anesthesiologists score, femoral neck fracture, hemoglobin, hematocrit

CLC Number:

R459.9|R604|R318

Gao Zhixiang, Jiang Yishan, Long Nengji, Xiao Cong. Risk factors for postoperative delirium in elderly patients after total hip arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(32): 5097-5102.

Figures/Tables 3

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