Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period
Abstract To investigate the incidence rate and risk factors of postoperative delirium in middle-aged and elderly patients with fracture. A total of 648 middle-aged and elderly fracture patients who underwent surgical treatment in our hospital from January 2018 to December 2020 were included in the s...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-40090-z |
| _version_ | 1797453084007333888 |
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| author | Zhongcheng An Liangen Xiao Chen Chen Lianguo Wu Hao Wei Xiaoping Zhang Liqiang Dong |
| author_facet | Zhongcheng An Liangen Xiao Chen Chen Lianguo Wu Hao Wei Xiaoping Zhang Liqiang Dong |
| author_sort | Zhongcheng An |
| collection | DOAJ |
| description | Abstract To investigate the incidence rate and risk factors of postoperative delirium in middle-aged and elderly patients with fracture. A total of 648 middle-aged and elderly fracture patients who underwent surgical treatment in our hospital from January 2018 to December 2020 were included in the study, aged 50–103 years, mean 70.10 ± 11.37 years. The incidence of postoperative delirium was analyzed. Univariate analysis was used to screen the risk factors of gender, age, interval between injury and operation, preoperative complications, fracture site, anesthesia method, operation time, intraoperative blood loss, hidden blood loss and hormone use. For the factors with P < 0.05, multivariate logistic regression analysis was used to determine the main independent risk factors. 115 cases (17.74%) of 648 patients had postoperative delirium. Univariate analysis showed that patients with delirium and patients without delirium had significant correlation in age, medical disease comorbidity, fracture type, anesthesia method, operation time and perioperative blood loss (P < 0.05). Multivariate logistic regression analysis showed that age (OR = 1.061), preoperative complications (OR = 1.667), perioperative blood loss (OR = 1.002) were positively correlated with postoperative delirium. It shows that older age, more preoperative complications, longer operation time and more perioperative bleeding are more likely to lead to postoperative delirium; patients with general anesthesia were more likely to develop postoperative delirium than patients with local anesthesia (OR = 1.628); and patients with hip and pelvic fractures are more likely to develop a postoperative delirious state (OR = 1.316). Advanced age, complex orthopedic surgery, more medical comorbidities, general anesthesia and greater perioperative blood loss may be independent risk factors for the development of delirium after internal fixation of fractures in middle-aged and elderly patients. |
| first_indexed | 2024-03-09T15:17:50Z |
| format | Article |
| id | doaj.art-ba068e2257584ae7b179da6b156251d7 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:17:50Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ba068e2257584ae7b179da6b156251d72023-11-26T13:01:10ZengNature PortfolioScientific Reports2045-23222023-08-011311610.1038/s41598-023-40090-zAnalysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative periodZhongcheng An0Liangen Xiao1Chen Chen2Lianguo Wu3Hao Wei4Xiaoping Zhang5Liqiang Dong6Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityThe Second Clinical Medical College of Zhejiang Chinese Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityDepartment of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical UniversityAbstract To investigate the incidence rate and risk factors of postoperative delirium in middle-aged and elderly patients with fracture. A total of 648 middle-aged and elderly fracture patients who underwent surgical treatment in our hospital from January 2018 to December 2020 were included in the study, aged 50–103 years, mean 70.10 ± 11.37 years. The incidence of postoperative delirium was analyzed. Univariate analysis was used to screen the risk factors of gender, age, interval between injury and operation, preoperative complications, fracture site, anesthesia method, operation time, intraoperative blood loss, hidden blood loss and hormone use. For the factors with P < 0.05, multivariate logistic regression analysis was used to determine the main independent risk factors. 115 cases (17.74%) of 648 patients had postoperative delirium. Univariate analysis showed that patients with delirium and patients without delirium had significant correlation in age, medical disease comorbidity, fracture type, anesthesia method, operation time and perioperative blood loss (P < 0.05). Multivariate logistic regression analysis showed that age (OR = 1.061), preoperative complications (OR = 1.667), perioperative blood loss (OR = 1.002) were positively correlated with postoperative delirium. It shows that older age, more preoperative complications, longer operation time and more perioperative bleeding are more likely to lead to postoperative delirium; patients with general anesthesia were more likely to develop postoperative delirium than patients with local anesthesia (OR = 1.628); and patients with hip and pelvic fractures are more likely to develop a postoperative delirious state (OR = 1.316). Advanced age, complex orthopedic surgery, more medical comorbidities, general anesthesia and greater perioperative blood loss may be independent risk factors for the development of delirium after internal fixation of fractures in middle-aged and elderly patients.https://doi.org/10.1038/s41598-023-40090-z |
| spellingShingle | Zhongcheng An Liangen Xiao Chen Chen Lianguo Wu Hao Wei Xiaoping Zhang Liqiang Dong Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period Scientific Reports |
| title | Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period |
| title_full | Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period |
| title_fullStr | Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period |
| title_full_unstemmed | Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period |
| title_short | Analysis of risk factors for postoperative delirium in middle-aged and elderly fracture patients in the perioperative period |
| title_sort | analysis of risk factors for postoperative delirium in middle aged and elderly fracture patients in the perioperative period |
| url | https://doi.org/10.1038/s41598-023-40090-z |
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