Evidence map›Paper›PMID 40354105›Full record

ArticleInternational journal of geriatric psychiatry2025

Incidence and Risk Factors of Postoperative Delirium in Elderly Patients Following Hip Fracture Surgery: A Nationwide Retrospective Cohort Study in Taiwan.

Chien-An Shih, Deng-Chi Yang, Wei-Ming Wang, Yi-Lin Wu, Yi-Ching Yang, Han-Chang Ku

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Article in International journal of geriatric psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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3 · Its place in the literature

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4 citing papers in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Chien-An ShihDepartment of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Deng-Chi YangDepartment of Geriatrics and Gerontology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-2183-8019
Wei-Ming WangDepartment of Statistics and Information Science, Fu Jen Catholic University, New Taipei City, Taiwan.ORCID 0000-0001-8907-875X
Yi-Lin WuDepartment of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0002-2747-7015
Yi-Ching YangDepartment of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.ORCID 0000-0003-1391-8040
Han-Chang KuDepartment of Nursing, Chang Gung University of Science and Technology, Chiayi Branch, Chiayi, Taiwan.ORCID 0000-0001-9371-0607

Funding

National Health Research Institutes 13A1-CG-CO-04-2225-1
6 · The paper itself

Abstract

backgroundDelirium is an acute cognitive change characterized by behavioral and psychological features, such as visual and auditory hallucinations, sleep disturbances, and emotional confusion. It can lead to extended hospital stays, increased mortality risk, and higher nursing costs. In postoperative hip fracture patients, delirium results in a higher complication rate, poorer functional recovery, increased readmission rates, repeat surgeries, and elevated mortality. Despite these serious consequences, the literature provides limited information on the incidence of postoperative delirium following hip fracture surgeries in Asians. Additionally, there is a lack of long-term, comprehensive nationwide population-based studies, highlighting an important area for future research. This study aims to understand the incidence and risk factors of postoperative delirium in hip fracture patients using representative population data.

methodsWe conducted a retrospective cohort study using the Taiwan National Health Insurance Research Database (NHIRD) from 2009 to 2020. The cohort consisted of 118,682 patients aged 65 years or older who were diagnosed with hip fractures. The delirium incidence was observed per 1000 person-years. The Cox proportional hazards model was used to investigate the incidence of delirium among hip fracture patients.

resultsThe incidence of the first episode of delirium after hip surgery in the elderly was 1.87 events per 1000 PYs. Factors associated with delirium included being female (adjusted hazard ratio [aHR]: 0.59; 95% confidence interval [CI]: 0.53-0.64), age ≥ 95 years (aHR: 3.52; 95% CI: 2.74-4.51), comorbid dementia (aHR: 2.63; 95% CI: 2.38-2.92), and ICU stay 2-3 days (aHR: 2.85; 95% CI: 1.28-6.37). The occurrence of delirium was significantly associated with an ICU stay of ≥ 4 days, dementia, as well as 30-day, 90-day, and 1-year mortality (p < 0.001).

conclusionsThis study highlights the relatively low incidence of postoperative delirium in elderly hip fracture patients in Taiwan. Key risk factors identified include advanced age, female gender, comorbid dementia, and prolonged ICU stays. These findings underscore the need for targeted prevention and early intervention strategies to improve patient outcomes.

Indexed as

DeliriumHip FracturesPostoperative ComplicationsAgedAged, 80 and overFemaleHumansIncidenceMaleProportional Hazards ModelsRetrospective StudiesRisk FactorsSex FactorsTaiwancohort studydeliriumelderlyhip fractureincidencesurgery

Identifiers

PMID40354105
PMCPMC12068420

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