Original Article

J Korean Hip Soc 2010; 22(2): 151-158

Published online June 1, 2010

© The Korean Hip Society

Postoperative Delirium after Hip Arthroplasty in the Elderly

Sung Kwan Hwang, MD, PhD, Chang Ho Lee, MD

Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea

Correspondence to : Sung Kwan Hwang MD, PhD
Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, 162 Ilsan-dong,Wonju 220-701, Korea
TEL: +82-33-741-1351 FAX: +82-33-746-7326
E-mail: hwtonlka@yonsei.ac.kr

Received: March 15, 2010; Revised: June 14, 2010; Accepted: June 16, 2010

Abstract

Purpose: Our study was done to evaluate the influence of postoperative delirium on the prognosis of hip arthroplasty, and risk factors for postoperative delirium in individuals older than 65.
Materials and Methods: Among patients who received hip arthroplasty in our hospital (WCH) between March 2004 and March 2008, we chose 193 patients for our study after excluding patients who had preoperative delirium and who had a history of dementia and cognitive dysfunction. We divided our cohort of 193 patients into two groups, 131 patients with postoperative delirium and 62 patients without delirium. We checked for clinical results for hip arthroplasty. We checked for multiple factors related to delirium.
Results: The mean hospital stay was 42.4±14.0 in the delirium group and 20.4±4.3 in the control group; the difference was significant. The mean preoperative cumulative ambulation score was 1.9±1.2 in the delirium group and 3.1±1.7 in the control group; the difference was significant. In 2 individuals of the control group and 4 of the delirium group, dislocation developed;and there was significant difference. There was a high prevalence of delirium among patients with hip fractures, and of histories of psychiatric diseases, alcohol abuse, liver cirrhosis and cerebral vascular disease. The delirium group had a significantly longer stay in the intensive care unit. On admission, the delirium group had significantly lower sodium and albumin compared to controls.
Conclusion: Because postoperative delirium after hip arthroplasty makes the prognosis worse, preoperative evaluation and management of risk factors is necessary.

Keywords Hip arthroplasty, Delirium, Elderly

Article

Original Article

J Korean Hip Soc 2010; 22(2): 151-158

Published online June 1, 2010 https://doi.org/10.5371/jkhs.2010.22.2.151

Copyright © The Korean Hip Society.

Postoperative Delirium after Hip Arthroplasty in the Elderly

Sung Kwan Hwang, MD, PhD, Chang Ho Lee, MD

Department of Orthopedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea

Correspondence to:Sung Kwan Hwang MD, PhD
Department of Orthopedic Surgery, Yonsei University Wonju College of Medicine, 162 Ilsan-dong,Wonju 220-701, Korea
TEL: +82-33-741-1351 FAX: +82-33-746-7326
E-mail: hwtonlka@yonsei.ac.kr

Received: March 15, 2010; Revised: June 14, 2010; Accepted: June 16, 2010

Abstract

Purpose: Our study was done to evaluate the influence of postoperative delirium on the prognosis of hip arthroplasty, and risk factors for postoperative delirium in individuals older than 65.
Materials and Methods: Among patients who received hip arthroplasty in our hospital (WCH) between March 2004 and March 2008, we chose 193 patients for our study after excluding patients who had preoperative delirium and who had a history of dementia and cognitive dysfunction. We divided our cohort of 193 patients into two groups, 131 patients with postoperative delirium and 62 patients without delirium. We checked for clinical results for hip arthroplasty. We checked for multiple factors related to delirium.
Results: The mean hospital stay was 42.4±14.0 in the delirium group and 20.4±4.3 in the control group; the difference was significant. The mean preoperative cumulative ambulation score was 1.9±1.2 in the delirium group and 3.1±1.7 in the control group; the difference was significant. In 2 individuals of the control group and 4 of the delirium group, dislocation developed;and there was significant difference. There was a high prevalence of delirium among patients with hip fractures, and of histories of psychiatric diseases, alcohol abuse, liver cirrhosis and cerebral vascular disease. The delirium group had a significantly longer stay in the intensive care unit. On admission, the delirium group had significantly lower sodium and albumin compared to controls.
Conclusion: Because postoperative delirium after hip arthroplasty makes the prognosis worse, preoperative evaluation and management of risk factors is necessary.

Keywords: Hip arthroplasty, Delirium, Elderly

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