J Korean Orthop Assoc.  2019 Apr;54(2):157-163. 10.4055/jkoa.2019.54.2.157.

Incidence and Associated Factors of Delirium after Orthopedic Surgery

Affiliations
  • 1Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea. oscho5362@dsmc.or.kr

Abstract

PURPOSE
To investigate the incidence and associated factors of delirium after orthopedic surgery.
MATERIALS AND METHODS
A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed.
RESULTS
The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54–92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders.
CONCLUSION
The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

Keyword

delirium; orthopedics
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