| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 106 === Background: Orthopedic surgery is the best treatment recommended for hip fractures, however, the procedure often induce postoperative delirium. Any age group is susceptible to postoperative delirium, but high prevalence rates of post-operative delirium have been found in geriatric patients with hip fracture.
Purpose: There is a lack of research focused on the geriatric population with hip fracture. The purpose of this study was to establish the incidence rate of post-operative delirium among elderly patients and to identify risk factors.
Methods: A prospective observational design with repeated measures was used. Subjects older than 65 years who had suffer from hip fracture due to fall will be recruited when admitted in orthopedic ward. The Confusion Assessment Method will be the study tool to assess twice a day to identify subjects experiencing delirium by research team. The demographic data, history of illness, operation process, and laboratory data of the patients were recorded. The demographic data of participants were analyzed to obtain the logistic regression to identify factors associated with the odds ratio.
Result: There were One hundred-and-two participants had been screened, and nine of whom was excluded due to the pre-existing delirium. Ninety-three participants with hip fracture were included. The incidence rate of delirium was 54.8%. The average age was 84.5. When postoperative delirium occurred, time to ambulation after surgery was delayed and the average ambulation time per day was decreased. The risk factors were analyzed by logistic regression. Univariate regression suggested age, religion, MMSE (Mini-Mental State Examination), hemoglobin, and hematocrit may be associated to postoperative delirium. Multivariate regression suggested MMSE was a significant risk factor of postoperative delirium in hip fracture.
Conclusion: Postoperative delirium has significant impacts on the recovery and long term well-being of elderly patients. Significant predictive risk factors can be parsed out to help practitioners identify patients who are more susceptible to postoperative delirium before they receiving surgery. Recognizing patients who are more likely to develop delirium can also help practitioners develop individualized management to extend postoperative monitoring as needed and mitigate surgical risk factors.
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