Preoperative Risk Factors for Subsyndromal Delirium in Older Adults Who Undergo Joint Replacement Surgery

Orthop Nurs. 2017 Nov/Dec;36(6):402-411. doi: 10.1097/NOR.0000000000000401.

Abstract

Background: Older adults with subsyndromal delirium have similar risks for adverse outcomes following joint replacement surgery as those who suffer from delirium.

Purpose: This study examined relationships among subsyndromal delirium and select preoperative risk factors in older adults following major orthopaedic surgery.

Methods: Delirium assessments of a sample of 62 adults 65 years of age or older were completed on postoperative Days 1, 2, and 3 following joint replacement surgery. Data were analyzed for relationships among delirium symptoms and the following preoperative risk factors: increased comorbidity burden, cognitive impairment, fall history, and preoperative fasting time.

Results: Postoperative subsyndromal delirium occurred in 68% of study participants. A recent fall history and a longer preoperative fasting time were associated with delirium symptoms (p ≤ .05).

Conclusions: Older adults with a recent history of falls within the past 6 months or a longer duration of preoperative fasting time may be at higher risk for delirium symptoms following joint replacement surgery.

MeSH terms

  • Accidental Falls / prevention & control
  • Aged
  • Arthroplasty, Replacement / methods*
  • Comorbidity*
  • Delirium / diagnosis*
  • Female
  • Humans
  • Male
  • Postoperative Complications*
  • Prospective Studies
  • Risk Factors
  • Time Factors