Clin Orthop Surg.  2019 Sep;11(3):297-301. 10.4055/cios.2019.11.3.297.

Etiology and Related Factors of Postoperative Delirium in Orthopedic Surgery

Affiliations
  • 1Department of Orthopedic Surgery, Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Korea.
  • 2Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University Medical School, Busan, Korea. alla1013@naver.com

Abstract

BACKGROUND
Delirium is a serious complication for elderly patients after orthopedic surgery. The purpose of this study was to assess the etiology and related factors of delirium after orthopedic surgery in Korea.
METHODS
We retrospectively reviewed the medical records of 3,611 patients over 50 years who had orthopedic surgery. The age of patients (50s, 60s, 70s, and > 80s), type of anesthesia (general, spinal, and local), operation time (more than 2 hours vs. less than 2 hours), surgical site (spine, hip, knee, or others), and etiology (trauma or disease) were compared to determine possible risk factors of delirium after orthopedic surgery.
RESULTS
Of 3,611 patients, 172 (4.76%) were diagnosed with delirium after orthopedic surgery. Postoperative delirium occurred in 1.18% in their 50s, 3.86% in their 60s, 8.49% in their 70s, and 13.04% in > 80s (p < 0.001). According to anesthesia type, 6.50% of postoperative delirium occurred after general anesthesia, 0.77% after spinal anesthesia, and 0.47% after local anesthesia (p < 0.001). More than 2 hours of operation was associated with higher occurrence of delirium than less than 2 hours was (5.88% vs. 4.13%, p = 0.017). For the etiology, 8.17% were trauma cases and 3.02% were disease (p < 0.001). Postoperative delirium occurred in 22 of 493 patients (4.46%) after spine surgery, 18 of 355 patients (5.07%) after hip surgery, 17 of 394 patients (4.31%) after knee surgery, and 15 of 1,145 patients (1.31%) after surgery at other sites (p < 0.001).
CONCLUSIONS
Postoperative delirium was more common in older patients who had surgery under general anesthesia, whose surgery took more than 2 hours, and who were hospitalized through the emergency room.

Keyword

Delirium; Orthopedic surgery; Etiology; Risk factor

MeSH Terms

Aged
Anesthesia
Anesthesia, General
Anesthesia, Local
Anesthesia, Spinal
Delirium*
Emergency Service, Hospital
Hip
Humans
Knee
Korea
Medical Records
Orthopedics*
Retrospective Studies
Risk Factors
Spine
Full Text Links
  • CIOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error