Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia.
Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia.
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DOI：
10.1111/j.1532-5415.2011.03725.x
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发表时间：
2011-12
影响因子：
6.3
通讯作者：
Sieber FE
中科院分区：
文献类型：
--
作者：
Lee HB;Mears SC;Rosenberg PB;Leoutsakos JM;Gottschalk A;Sieber FE
Based on a multi-factorial model of delirium, we compared the types and magnitude of pre- and intra-operative predisposing factors for incident delirium in a stratified sample of acute hip fracture repair patients with and without pre-operative dementia. A prospective cohort study based in an academic medical center. 425 non-delirious, acute hip fracture patients (mean age: 80.2 +/− 6.8; female: 73.2%; “probable dementia”: 33.1%) admitted to the multi-disciplinary hip fracture repair service. Each participant was assessed for delirium by a research nurse based on the Confusion Assessment Method (CAM) before study enrollment and from the second postoperative day until hospital discharge. The incidence of delirium was higher in the Probable Dementia Group than in the No Dementia Group (54% vs. 26%; p≤ 0.001). In the No Dementia group (n = 284), age (OR: 1.07; 95% CI: 1.02-1.13), male gender (OR: 2.81; 95% CI: 1.40-5.64), BMI (OR: 0.92; 95% CI: 0.86-0.99), number of medical comorbidities (OR: 1.15; 95% CI: 1.01-1.32), and duration of surgery longer than two hours (OR: 2.53; 95% CI: 1.20-4.88) were independently associated with a post-operative delirium. In the Probable Dementia group, only the lag time from emergency room to operation room was significantly associated (OR: 2.83; 95% CI: 1.24-2.25) with delirium. Pre-operative determination of dementia status is important for risk stratification for incident delirium after acute hip fracture repair surgery because types and magnitude of predisposing risk factors for post-operative delirium substantially differ based on their pre-operative dementia status.
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DOI：
10.1093/gerona/60.6.748
发表时间：
2005-06-01
影响因子：
5.1
作者：
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DOI：
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影响因子：
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