Abstract

Background: Delirium is the most common complication as well as the most significant cause of various clinical outcomes in older adults who undergo hip fracture surgery. However, there is scarce consensus on this. This study aimed to investigate the risk factors for delirium, its incidence and features, and clinical outcomes in Korean older adults who had undergone hip fracture surgery.

Methods: This retrospective study was conducted at Gyeonggi Provincial Medical Center Paju Hospital. Data (N = 231) were obtained between January 2016 and May 2019 using electronic medical records. Delirium was evaluated using a Korean version of the Nursing Delirium Screening Scale. The data were analyzed using descriptive statistics, independent t-test, chi-squared test, and logistic regression using SPSS 23.0 software.

Results: The incidence of delirium among older adults after hip fracture surgery was 45%. Multiple logistic regression identified higher age (odds ratio [OR] = 1.72, p < 0.001), low albumin level (OR = 2.65, p = 0.005), high creatinine level (OR = 2.97, p = 0.003), and dependent mobility status (OR = 3.84, p < 0.001) as risk factors for delirium. Compared to the non-delirium group, the delirium group was more likely to be admitted to a nursing home instead of returning home after discharge, owing to their inability to carry on independent living, and had significantly higher postoperative complications as well as fall, one-year readmission, and mortality rates.

Conclusion: Older adults are vulnerable to delirium after hip fracture surgery. Patients who experience delirium are at an elevated risk for complications and worsening of clinical outcomes. Therefore, multidisciplinary action and management efforts are needed.