Incidence and risk factors of acute delirium in older patients with hip fracture in Siriraj Hospital
Muangpaisan, W.; Wongprikron, A.; Srinonprasert, V.; Suwanpatoomlerd, S.; Sutipornpalangkul, W.; Assantchai, P.
Journal of the Medical Association of Thailand 98(4): 423-430
2015
ISSN/ISBN: 0125-2208 PMID: 25958719 Document Number: 16600
To determine the incidence and associated factors of delirium in older patients admitted with hip fracture. Eighty patients with fall-related hip fracture who admitted to orthopedics wards in Siriraj Hospital were recruited. Baseline characteristics, functional ability and cognitive status, treatment-related factors, clinical outcomes, length of stay, and direct medical cost were evaluated. Delirium was diagnosed by experienced geriatricians using DSM-IV RESULTS: Thirty-six patients (45%,) developed delirium. Hyperactive and hypoactive delirium was 24:12 patients. Preoperative and postoperative delirium was developed in 18:18 patients. Age, TMSE score on admission, modified IQCODE score, premorbid mRS, receiving NSAIDs around the clock postoperatively, and sedative drug use were significantly different between the non-delirium and delirium groups in multivariate logistic regression analysis. Patients with delirium did not have significantly higher postoperative complications, hospital length ofstay, functional status (mRS) at discharge, mortality, and direct cost of the treatment in hospital. Delirium is common in elderly hip fracture undergoing hip repair. Age, premorbid function, dementia/cognitive impairment, NSAIDs, and sedative use were associated factors of delirium. Identifying those with high-risk factors should be routinely performed rigorously and strategies to reduce delirium incidence and severity should be planned and conducted.
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