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- Title
Postoperative delirium in geriatric patients with hip fractures.
- Authors
Yang Chen; Shuai Liang; Huiwen Wu; Shihao Deng; Fangyuan Wang; Ciren Lunzhu; Jun Li
- Abstract
Postoperative delirium (POD) is a frequent complication in geriatric patients with hip fractures, which is linked to poorer functional recovery, longer hospital stays, and higher short-and long-term mortality. Patients with increased age, preoperative cognitive impairment, comorbidities, perioperative polypharmacy, and delayed surgery are more prone to develop POD after hip fracture surgery. In this narrative review, we outlined the latest findings on postoperative delirium in geriatric patients with hip fractures, focusing on its pathophysiology, diagnosis, prevention, and treatment. Perioperative risk prediction, avoidance of certain medications, and orthogeriatric comprehensive care are all examples of effective interventions. Choices of anesthesia technique may not be associated with a significant difference in the incidence of postoperative delirium in geriatric patients with hip fractures. There are few pharmaceutical measures available for POD treatment. Dexmedetomidine and multimodal analgesia may be effective for managing postoperative delirium, and adverse complications should be considered when using antipsychotics. In conclusion, perioperative risk intervention based on orthogeriatric comprehensive care is the most effective strategy for preventing postoperative delirium in geriatric patients with hip fractures.
- Subjects
RISK of delirium; SURGICAL complication risk factors; DIAGNOSIS of delirium; COGNITION disorders; LENGTH of stay in hospitals; PERIOPERATIVE care; BIOMARKERS; FUNCTIONAL status; CONVALESCENCE; AGE distribution; POLYPHARMACY; HIP fractures; RISK assessment; HOSPITAL mortality; NEUROINFLAMMATION; SEVERITY of illness index; IMIDAZOLES; DELIRIUM; PREDICTION models; ELDER care; COMORBIDITY
- Publication
Frontiers in Aging Neuroscience, 2022, Vol 14, p1
- ISSN
1663-4365
- Publication type
Article
- DOI
10.3389/fnagi.2022.1068278