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Association of preoperative frailty with the risk of postoperative delirium in older patients undergoing hip fracture surgery: a prospective cohort study

谵妄 医学 前瞻性队列研究 髋部骨折 队列 队列研究 髋关节手术 联想(心理学) 外科 老年学 骨质疏松症 内科学 关节置换术 精神科 心理学 心理治疗师
作者
Feng Cao,H. R. Wu,Ziheng Qi,Yibin Wei,Bo Yang,Haolin Yin,Siyi Yan,Lu Wang,Yangyang Yu,Juan‐Juan Xie,Xueyan Xing,Shenghao Tu,Huan Zhang
出处
期刊:Aging Clinical and Experimental Research [Springer Science+Business Media]
卷期号:36 (1)
标识
DOI:10.1007/s40520-023-02692-5
摘要

Abstract Objective This study aimed to explore the correlation between preoperative frailty and the risk of postoperative delirium (POD) in older patients undergoing hip fracture surgery. Methods In total, 148 patients with hip fractures who were admitted to Tsinghua Changgung Hospital (Beijing, China) between January 2022 and January 2023 were involved in this study. Preoperative frailty scales were assessed, of which the CAM scale was postoperatively administered every morning and evening on days 1, 2, 3, 5, and 7. Binary logistic regression analysis was conducted to determine the correlation between preoperative frailty and the risk of POD. Results Among 148 older patients with hip fractures, 71 (48.0%) were identified as preoperative frail and 77 (52.0%) as non-frail. The overall incidence of POD on day 7 was 24.3% (36/148), and preoperative frailty was associated with a significantly higher risk of POD compared with non-frailty (42.3% vs. 7.8%, P < 0.001). The binary logistic regression analysis revealed that preoperative frailty was noted as an independent risk factor for the risk of POD in older patients undergoing hip fracture surgery ( P = 0.002). Conclusion Preoperative frailty increased the risk of POD in older patients undergoing hip fracture surgery. Discussion Preoperative assessment of frailty in geriatric hip surgery can timely identify potential risks and provide interventions targeting frailty factors to reduce the incidence of POD in older patients undergoing hip fracture surgery. The findings suggested that preoperative frailty could increase the risk of POD in older patients undergoing hip fracture surgery. Further research is necessary to determine whether perioperative interventions aimed at enhancing frailty can mitigate the risk of POD and improve prognosis in older patients undergoing hip fracture surgery.
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