Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes

Lee, Deng Horng; Chang, Chih-Hsun; Chang, Chih-Hung; Chen, Yi‐Chen; Tai, Ta-Wei

doi:10.1016/j.arth.2022.10.022

Cited by 6 publications

(3 citation statements)

References 76 publications

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“…In addition, Lu et al reported that SIRI was positively correlated with the occurrence of postoperative delirium in older patients with hip arthroplasty surgery ( 44 ). Numerous studies have confirmed that postoperative delirium in hip fracture patients was obviously associated with poor outcomes, including higher mortality ( 45 , 46 ). Thus, the positive association between SIRI and mortality may be partially explained by its association with complications after hip fracture.…”

Section: Discussionmentioning

confidence: 99%

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Fang,

Gao,

Wang

et al. 2024

Front. Med.

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ObjectiveWith a rapidly aging global population, the assessment of mortality risk following hip fracture in older adults has received increasing attention. Recently, the system inflammation response index (SIRI) has been identified as a novel prognostic marker to reflect both systemic inflammation and immune status. However, it is not yet known whether SIRI is a potential predictor of subsequent death in hip fracture patients. Therefore, this study aimed to investigate the association between SIRI and mortality in older patients with hip fracture.MethodsA total of 1,206 older hip fracture patients undergoing surgery between January 2013 and December 2022 were consecutively derived from our longitudinal database. Patients were divided into three groups according to SIRI tertiles, calculated as neutrophil × monocyte / lymphocyte. Survival status was obtained from medical records or telephone interviews, and the study outcome was all-cause mortality after hip fracture at the longest follow-up. Multivariate Cox proportional hazard model and restricted cubic spline (RCS) regression model were used to evaluate the association between SIRI and mortality. Moreover, a series of sensitivity analyses were conducted to further validate the robustness of the association.ResultsDuring a median follow-up of 43.85 months, 337 patients (27.94%) died. After full adjustment, each unit increase in SIRI was significantly associated with a 2.2% increase in overall mortality (95% confidence interval [CI]: 1.001–1.042, p = 0.029). Similarly, compared with the first tertile of SIRI, the second and third tertile showed a 1.335-fold (95% CI: 1.011–1.762, p = 0.042) and 1.447-fold (95% CI, 1.093–1.917, p = 0.010) higher risk of death. Sensitivity analyses confirmed the stability of the association. Moreover, RCS analysis revealed a positive non-linear relationship between SIRI and mortality (P for nonlinearity = 0.021).ConclusionHigh SIRI level at admission was significantly and positively associated with an increased risk of death, suggesting that SIRI may be an independent predictor of mortality in older patients with hip fracture.

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Section: Discussionmentioning

confidence: 99%

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Fang,

Gao,

Wang

et al. 2024

Front. Med.

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“…Studies indicate a postoperative delirium incidence of up to 44% among elderly FNF patients. Alarmingly, the mortality rate is about three times higher in those who experience delirium compared to those who do not [5]. The scholarly consensus highlights the importance of preventing delirium, which far outweighs the value of treating it once it has occurred.…”

Section: Introductionmentioning

confidence: 99%

“…Enter the Enhanced Recovery After Surgery (ERAS) nursing model. This modern approach to perioperative care integrates a suite of evidence-based interventions aimed at expediting patient recovery [5]. ERAS has seen increasing adoption across various clinical disciplines, with impressive results attesting to its effectiveness.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Perioperative Enhanced Recovery Nursing Model on Postoperative Delirium and Rehabilitation Quality in Elderly Patients with Femoral Neck Fractures

Wang

Tan

Qin

2023

Preprint

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Background The aim of this study was to investigate the effects of introducing the Enhanced Recovery After Surgery (ERAS) nursing model on postoperative delirium occurrence and rehabilitation quality in elderly patients with femoral neck fractures. Methods A total of 160 elderly patients with femoral neck fractures, who met the inclusion criteria and were admitted between March 2021 to March 2023, were divided into two groups: the traditional care group and the ERAS nursing model group. In addition to traditional care measures, the ERAS nursing model group received interventions based on the principles of the ERAS nursing model. The occurrence of delirium and sleep quality were observed at 24, 48, and 72 hours postoperatively, as well as during the overall hospital stay. The duration of hospitalization, time to first mobilization, and post-discharge follow-up on quality of life were compared between the two groups. Results The ERAS nursing model group exhibited a significant difference in the occurrence of delirium at 48 and 72 hours postoperatively, as well as during the overall hospital stay (P < 0.05). However, there was no significant difference in the occurrence of delirium at 24 hours postoperatively (P > 0.05). The sleep quality of the two groups showed a statistically significant difference (P < 0.05). The ERAS nursing model group had shorter time to first mobilization, reduced hospitalization duration, and higher Harris and SF-36 scores during post-discharge follow-up, compared to the traditional care group (P < 0.05). Conclusions The implementation of the ERAS nursing model in elderly patients with femoral neck fractures improved postoperative sleep quality, reduced delirium occurrence, shortened average hospitalization duration, and enhanced patients' quality of life.

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Study on the predictive model of delirium risk after surgery for elderly hip fractures based on meta-analysis

Wan,

Li,

Zou

et al. 2024

Eur Geriatr Med

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Postoperative Delirium in Patients Receiving Hip Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures: The Risk Factors and Further Clinical Outcomes

Cited by 6 publications

References 76 publications

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

The Impact of Perioperative Enhanced Recovery Nursing Model on Postoperative Delirium and Rehabilitation Quality in Elderly Patients with Femoral Neck Fractures

Study on the predictive model of delirium risk after surgery for elderly hip fractures based on meta-analysis

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