Subtypes and duration of postoperative delirium in elderly hip fracture patients and its impact on survival rate
10.3760/cma.j.cn115682-20240408-01914
- VernacularTitle:老年髋部骨折患者术后谵妄亚型及持续时间对生存率的影响
- Author:
Xiuling WU
1
;
Juhong LOU
1
;
Zhenzhen ZHOU
1
Author Information
1. 浙江省台州医院骨科，台州 317000
- Publication Type:Journal Article
- Keywords:
Aged;
Hip fracture;
Postoperative delirium;
Survival rate;
Delirium subtype
- From:
Chinese Journal of Modern Nursing
2025;31(7):933-939
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the subtypes and duration of postoperative delirium in elderly hip fracture patients and analyze the impact of delirium in 6 months postoperative mortality.Methods:A convenience sampling method was used to select elderly hip fracture patients who underwent surgery at Taizhou Hospital of Zhejiang Province from April 2021 to October 2023. General information and cognitive status were assessed using a demographic survey and the Mini-Mental State Examination. Postoperative delirium was evaluated and recorded twice daily for one week after surgery, distinguishing delirium subtypes. The differences in all-cause mortality within 6 months post-surgery among patients with different delirium subtypes were compared. Time-dependent Cox regression analysis was conducted to examine the impact of each subtype and duration of delirium on mortality.Results:A total of 662 questionnaires were distributed, with 659 valid responses (valid response rate was 99.55%). Among the 659 elderly hip fracture patients, 249 cases (37.78%) experienced delirium. Based on the occurrence and subtype of postoperative delirium, patients were divided into four groups: non-delirium group ( n=410), hyperactive group ( n=95), hypoactive group ( n=66), and mixed group ( n=88). At the end of the 6 months follow-up, 91 patients had died. The mortality rates were 8.05% (33/410) in the non-delirium group, 11.58% (11/95) in the hyperactive group, 39.39% (26/66) in the hypoactive group, and 23.86% (21/88) in the mixed group, with statistically significant differences among the groups ( P<0.01). Time-dependent Cox regression analysis indicated that the duration of delirium was independently associated with 6 months postoperative mortality in the hypoactive group [ HR=2.420, P<0.01] and the mixed group [ HR=3.049, P<0.01] . Conclusions:The incidence of postoperative delirium in elderly hip fracture patients is moderately high, with hyperactive delirium being the most common subtype. Hypoactive and mixed delirium subtypes are independently associated with increased 6 months postoperative mortality. Prolonged delirium duration further increases the risk of death.
