Incidence and Risk Factors of Acute Delirium in Older
Patients with Hip Fracture in Siriraj Hospital
Weerasak Muangpaisan MD, MPhil*, Asita Wongprikron MD**,
Varalak Srinonprasert MD, MM**, Sarawut Suwanpatoomlerd MD**,
Werasak Sutipornpalangkul MD, PhD***, Prasert Assantchai MD, FRCP (London)*
Affiliation :
* Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the incidence and associated factors of delirium in older patients admitted with hip fracture.
Material and Method: Eighty patients with fall-related hip fracture who admitted to orthopedics wards in Siriraj Hospital
were recruited. Baseline characteristics, functional ability and cognitive status, treatment-related factors, clinical outcomes,
length of stay, and direct medical cost were evaluated. Delirium was diagnosed by experienced geriatricians using DSM-IV.
Results : Thirty-six patients (45%) developed delirium. Hyperactive and hypoactive delirium was 24:12 patients. Preoperative
and postoperative delirium was developed in 18:18 patients. Age, TMSE score on admission, modified IQCODE score,
premorbid mRS, receiving NSAIDs around the clock postoperatively, and sedative drug use were significantly different
between the non-delirium and delirium groups in multivariate logistic regression analysis. Patients with delirium did not
have significantly higher postoperative complications, hospital length of stay, functional status (mRS) at discharge, mortality,
and direct cost of the treatment in hospital.
Conclusion : Delirium is common in elderly hip fracture undergoing hip repair. Age, premorbid function, dementia/cognitive
impairment, NSAIDs, and sedative use were associated factors of delirium. Identifying those with high-risk factors should
be routinely performed rigorously and strategies to reduce delirium incidence and severity should be planned and conducted.
Keywords : Delirium, Hip fracture, Incidence, Cognitive impairment, Functional status
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