ArticleGeriatric orthopaedic surgery & rehabilitation2014
Predictors of Postoperative Cognitive Decline in Very Old Patients With Hip Fracture: A Retrospective Analysis.
Article in Geriatric orthopaedic surgery & rehabilitation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 5 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- The Effect of General Anesthesia vs. Regional Anesthesia on Postoperative Delirium-A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- A call to action for delirium research: Meta-analysis and regression of delirium associated mortality.BMC geriatrics · 2020Pooled it
- Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Perioperative Sleep Disturbances and Postoperative Delirium in Adult Patients: A Systematic Review and Meta-Analysis of Clinical Trials.Frontiers in psychiatry · 2020Pooled it
- Pooled it
- Successful General Anesthesia for Intertrochanteric Femur Fracture in a 101-Year-Old Patient: A Case Report.Cureus · 2026Article
- Article
- The effect of surgical technique on cognitive function in elderly patients with hip fractures: Proximal femoral nailing versus hemiarthroplasty.Joint diseases and related surgery · 2022Article
- Increased Serum Neuropeptide Galanin Level Is a Predictor of Cognitive Dysfunction in Patients with Hip Fracture.Disease markers · 2021Observational
- Article
- Delivering high quality hip fracture rehabilitation: the perspective of occupational and physical therapy practitioners.Disability and rehabilitation · 2018Article
- [Anesthesiological care of trauma patients in orthogeriatric co-management].Der Anaesthesist · 2017Review
- Prevalence and risk factors of postoperative delirium in elderly hip fracture patients.The Journal of international medical research · 2016Article
- [Anesthesiological care in orthogeriatric co-management. Perioperative treatment of geriatric trauma patients].Zeitschrift fur Gerontologie und Geriatrie · 2016Article
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Authors and funding
5 authors.
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Abstract
backgroundTo investigate incidence and predictors of the various postoperative cognitive declines in old patients with hip fracture.
methodsThis retrospective chart study evaluated 411 patients (age ≥80 years, follow-up 5 years). After exclusion of 82 patients (preexisting dementia or delirium), 70 patients showing either diagnosed postoperative delirium (POD; group 1; N = 18, 5.5%) or an unspecified cognitive dysfunction and behavior (group 2; N = 52, 15.8%) were analyzed and compared with those without any acute postoperative cerebral impairment (control group; N = 259, 78.7%). Medical history, anesthesiological, orthopedic, and rehabilitation data were assessed using the medical database of the hospital information system. Relative ratio was calculated with Fisher exact test: P value Bonferroni corrected ≤.003.
resultsAcute cognitive complications were observed in 70 (21.3%) patients. Our data in group 1 showed that patients with a medical history of stroke (relative risk [RR] = 16.2, P = .0001) or nicotine abuse (RR = 14.4, P = .001) and perioperative surgical bleeding (RR = 6.54, P = .002) are more likely to develop POD. Unspecified cognitive dysfunction and behavior (group 2) was significantly associated with a medical history of stroke (RR = 12.5, P = .0001) and postoperatively with depression (RR = 3.32, P = .001). In the follow-up, significantly more patients in group 1 (55.6%, RR = 21.8, P = .0001) and group 2 (13.5%, RR = 3.88, P = .001) developed dementia as compared to controls (1.9%). Mortality did not differ significantly between the groups (group 1: RR = 1.75, P = .5 and group 2: RR = 0.66, P = 1.0).
conclusionThese data show that various predictors can identify a greater likelihood of developing postoperative cognitive decline in very old patients with hip fracture. Not identifying or labeling of POD limits the opportunity for evaluation, treatment, and planning. Thus, routine cognitive assessments need to be performed in the scope of multidisciplinary orthogeriatric comanagement.
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