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Delirium More Common with Acute Hip Surgery

Emergency hip-surgery patients have four times the delirium risk as those who have elective procedure

THURSDAY, May 11 (HealthDay News) -- Cognitive impairment is the strongest predictor of postoperative delirium in elderly hip-replacement patients, with those undergoing an acute procedure more likely to have delirium than elective patients, according to a Dutch study published in the May issue of the Journal of the American Geriatrics Society.

Kees J. Kalisvaart, M.D., Ph.D., of Medical Center Alkmaar in Alkmaar, the Netherlands, and colleagues calculated the risk of postoperative delirium in 603 elderly hip-surgery patients aged 70 or older. Patients were sorted into low-risk, intermediate-risk and high-risk groups, depending on mental state, visual impairment, health status and blood urea nitrogen versus creatinine levels.

Overall, delirium was diagnosed in 3.8 percent of low-risk patients, 11.1 percent of intermediate-risk patients and 37.1 percent of high-risk patients. The strongest predictor for postoperative delirium was cognitive impairment. Contradicting previous studies, the researchers found age an independent risk factor for delirium. Emergency hip replacement patients ran four times the delirium risk as patients who had elective surgery.

"The medical risk factor model is valid for elderly hip-surgery patients," the authors write. "Cognitive impairment, age and type of admission are important risk factors for delirium in this surgical population."

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