The Related Risk Factors And Complications Analysis About Postoperative Delirium With Elderly Hip Fracture Patients

Objective:Hip fracture accounted for 7.01% of the body fracture in adult People.While accounting for 23.79% of the body bone fracture a hip fracture in the People over 65 years. High incidence of Postoperative complications in elderly hip fracture Patients, delirium condition is one of the most common Postoperative complications. By studying the incidence of Postoperative delirium(POD)in Patients with hip fracture and risk factors, in order to achieve reduce delirium, dealing with risk factors in time, improve the Purpose of the Patients after operation.Methods: Choose in May 2014- January 2015, our hospital senile bone a total of 289 Patients with hip fracture surgery treated(age were greater than 65) of the medical records; the confusion assessment method(confusion assessment method, CAM) as a diagnostic tool, to evaluate the Postoperative Patients. There are 63 Patients(21 male cases, 42 female cases) appear Postoperative delirium condition, total rate is 21.7%; The average age of 80.22 years(67-99). To the Patient’s age, gender, Preoperative complications, Preoperative cognitive state, fracture Position, admission to the operation time, operation modes, operation time, anesthesia, blood loss during surgery and factors related to Postoperative complications of the single factor analysis,x2 test and T test was used to P<0.05 for the significant difference; Have a significant difference to the single factor analysis verified the independent variables into the Logistic regression model for multiple factors analysis. Records of patients with postoperative complications, comparing the difference between the two groups.Results:The incidence of 63 cases of Postoperative delirium delirium was 21.7%. Single factor analysis showed that the occurrence of delirium or not in age is compared between two groups(P=0.017), Preoperative complications(P<0.001), and admission to operating time(P=0.041), anesthesia(P<0.001), low Protein following surgery(P=0.003), the difference was statistically significant; And sex, fracture Position, operation between the two groups, the differences between the operation time, blood loss during surgery, no statistical significance. Logistic regression analysis showed that age, three or more than three coexist Preoperative coexist disease incidence of Postoperative delirium and Postoperative Patients with low Protein as important risk factors.Delirium group of patients after surgery was susceptible to hypo albuminemia(39.6%) and pulmonary infection(30.1%), should be targeted prophylaxis.Conclusion: Postoperative delirium condition of hip fracture with older age, preoperative complications and prolonged hospital to surgery, anesthesia and postoperative low protein correlation. Positive treatment of preoperative complications, with less impact on the state of body whole body anesthesia, shortening the time of admission to surgery, can improve postoperative nutritional status in a certain extent, reduce the occurrence of delirium..