|Study||Procedure||Incidence of Delirium||Elderly?||N|
|Gottschalk 2015([FOOTNOTE=Gottschalk A, Hubbs J, Vikani AR, Gottschalk LB, Sieber FE. The Impact of Incident Postoperative Delirium on Survival of Elderly Patients After Surgery for Hip Fracture Repair. Anesth Analg. 2015;121(5):1336-1343.],[ANCHOR=],[LINK=])||Hip fracture repair||32.90%||Yes||459|
|Guo 2016([FOOTNOTE=Guo Y, Jia P, Zhang J, Wang X, Jiang H, Jiang W. Prevalence and risk factors of postoperative delirium in elderly hip fracture patients. J Int Med Res. 2016;44(2):317-327.],[ANCHOR=],[LINK=])||Hip fracture repair||21%||Yes||572|
|Lee 2011([FOOTNOTE=Lee KH, Ha YC, Lee YK, Kang H, Koo KH. Frequency, risk factors, and prognosis of prolonged delirium in elderly patients after hip fracture surgery. Clin Orthop Relat Res. 2011;469(9):2612-2620.],[ANCHOR=],[LINK=])||Hip fracture repair||30.20%||Yes||232|
|Mosk 2017([FOOTNOTE=Mosk CA, Mus M, Vroemen JP, et al. Dementia and delirium, the outcomes in elderly hip fracture patients. Clin Interv Aging. 2017;12:421-430.],[ANCHOR=],[LINK=])||Hip fracture repair||35%||Yes||566|
|Yang 2017([FOOTNOTE=Yang Y, Zhao X, Dong T, Yang Z, Zhang Q, Zhang Y. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis. Aging Clin Exp Res. 2017;29(2):115-126.],[ANCHOR=],[LINK=])||Hip fracture repair||24%||Yes||5364|
|Zywiel 20151||Hip fracture repair||48%||Yes||242|
Kat et al.([FOOTNOTE=Kat MG, Vreeswijk R, de Jonghe JF, et al. Long-term cognitive outcome of delirium in elderly hip surgery patients. A prospective matched controlled study over two and a half years. Dement Geriatr Cogn Disord. 2008;26(1):1-8.],[ANCHOR=],[LINK=]) prospectively matched 71 patients diagnosed with postoperative delirium with 41 controls without postoperative delirium who had a similar risk factor profile. Outcome was assessed in all patients 30 months after discharge. A significantly greater proportion of patients with postoperative delirium died, were diagnosed with dementia or mild cognitive impairment (MCI), or were institutionalized at 30 months.
|Diagnosis of dementia or MCI||1.8|
Bickel et al.([FOOTNOTE=Bickel H, Gradinger R, Kochs E, Forstl H. High risk of cognitive and functional decline after postoperative delirium. A three-year prospective study. Dement Geriatr Cogn Disord. 2008;26(1):26-31.],[ANCHOR=],[LINK=]) conducted preoperatively and postoperatively daily assessments of cognitive function in hip surgery patients aged 60 years or greater (n=200). Patient outcome was assessed among patients with and without postoperative delirium 8 and 38 months after discharge. Adjusted* logistic regression analysis established associations between delirium and cognitive impairment, subjective memory decline, and incident need for long-term care at 38 months.
|Adjusted* odds ratio 8 months after discharge||Adjusted* odds ratio 38 months after discharge|
|Complaints about memory decline after surgery||4.7||6.2|
|Incident need for long-term care||NS||5.7|
|*Adjusted for age, sex, medical comorbidity, and preoperative cognitive performance|
Elderly patients undergoing hip fracture repair (n=114) under propofol sedation with spinal anesthesia were randomized to receive either deep (BIS™ index values≈50) or light (BIS™ index values ≥80) sedition.([FOOTNOTE=Sieber FE, Zakriya KJ, Gottschalk A, et al. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc. 2010;85(1):18-26.],[ANCHOR=],[LINK=]) Postoperative delirium was assessed after the second day postoperatively. The light sedation group had a 50% reduction in delirium compared to the deep sedation group.