Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis

Abstract

Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent delirium after hip surgery.

Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis

“…According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5), delirium is a disturbance in attention and awareness with changes in cognition developing over a short period of time and fluctuating during the course of the day (European‐Delirium‐Association and American‐Delirium‐Society, ). Although some people with normal cognition may develop delirium when exposed to particular stress (Takacs et al ., ; Yang et al ., ; European‐Delirium‐Association and American‐Delirium‐Society, ), it generally occurs in older people with cognitive impairment, and in many cases, psychomotor disturbances of delirium include agitation (Inouye, ; Van et al ., ). Delirium occurs in about 20% of patients hospitalized in internal medicine departments and in 50% of older persons in intensive care units (Goldberg et al ., ; Noriega et al ., ; Inouye et al ., , b).…”

Minimizing Stress Response and Cognitive Dysfunction in Orthopedic Surgery: The Prospects of Epidural Anesthesia

“…We can conclude that epidural analgesia positively affects the immune system, preventing severe postoperative immuno suppression, which is particularly due to the increase in the number of CD-3-cells, B-cells, CD4/ CD8 ratio, and partially of NK-cells. In a previous study, higher cortisol levels postoperatively were shown to be associated with a higher chance of developing POCD [4,5,7,8] . Epidural anesthesia has an important influence on the modulation of the immune response in patients who underwent major orthopedic surgery.…”

“…Postoperative cognitive dysfunction (POCD) is a major consequence of this. It is essentially "deterioration in cognition temporally associated with surgery" [4,5] , and might lead to a higher mortality rate within three post-operative months [6] . A number of studies have revealed that the inflammatory response is a key factor in the development of postoperative cognitive dysfunction (POCD) [7][8][9][10] .…”

“…Currently, the risk factors of POCD have been accurately identified with the aid of evidence-based medicine. The factors include the severity, duration and type of surgical procedures, elderly age, previous chronic pain, and patients' education level, along with anesthesia awareness episodes or critical hypotension in the past [5,19] . At the same time, there are no conclusive data on the effect of anesthesia techniques on the development of POCD, and there is still little research into the role of regional anesthesia in POCD prevention.…”

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“…3 There is wide variation in reported rates of post-operative delirium. For elderly patients undergoing hip surgery, the reported incidence varies from 16% to 62% [4][5][6] with average rate of 35%. 7 Occurrence of post-operative delirium is associated with higher risk of perioperative complications like pulling out of intravenous lines, catheters, drains and dressings.…”