Authors (including presenting author) :
Chan WWV (1), Cheng WY (1), Chiu YYI (1), Wu NL (1), Lau YH (2), Lei WC (3), Lo YS (2), Ng L (2), Leung KK (1), Siu HL (1), Yip YW (1), Chiu L (2), Szeto SL (2), Cheung YP (1), Choi KL (1), Wong CSK (1), Choy WK (2), Lo KM (2), Chan KW (1), Chan TJ (1) & Ching KCK (2)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Prince of Wales Hospital
(2) Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital
(3) Department of Orthopaedics and Traumatology, Tai Po Hospital
Introduction :
Post-operative delirium (POD) is a serious and quintessential complication of hip surgery among geriatric patients, which can adversely affect outcomes of the surgery. It is vital to identify patients who are at risk for developing POD before surgery. By implementing preventive measures and early treatments, adverse outcomes specified to POD such as functional decline, prolonged hospitalization, and institutionalization can be minimized.
Objectives :
The objectives of the study are to investigate the risk factors contributing to POD in geri-hip fracture patients and develop a pre-operative assessment checklist.
Methodology :
Patients aged over 65 with hip fracture were recruited. Patients with POD were identified using 4AT. Assessment was done on admission before operation. Re-assessments were then done on the day of operation, followed from day 1 to day 7 post-operatively. Patients’ demographic data and hypothesized risk factors for POD were also collected.
Result & Outcome :
Total forty-eight cases were recruited and thirty-nine patients completed the study (n=39). Ten patients developed POD during the study period. There were statistical significances on patients’ 4AT score in terms of age (p=0.05), gender (p=0.035), length of stay (p=0.041), dementia diagnosis (p=0.002) and smoking habit (p=0.00).
The risk factors identified in the study show gross consistency with previous studies. A comprehensive study with larger sample size is proposed in order to recognize risk factors for developing POD screening checklist.
POD remains a common complication in elderly with hip fracture surgery with an incidence of 25.6% in the study. Identification of risk factors with pre-operative screening might help to predict, manage and even prevent POD. The ultimate goal is to set up a standardized framework and protocol.
