Delirium on hospital admission in aged hip fracture patients: prediction of mortality and 2-year functional outcomes

Hip fracture patients are at increased risk of confusion or delirium due to the trauma associated with the injury and the rapid progression to hospitalization and surgery, in addition to the pain and loss of function experienced. Hip fracture patients who develop delirium may require longer hospital...

Full description

Saved in:
Bibliographic Details
Published in:The journals of gerontology. Series A, Biological sciences and medical sciences Biological sciences and medical sciences, 2000-09, Vol.55 (9), p.M527-M534
Main Authors: Dolan, M M, Hawkes, W G, Zimmerman, S I, Morrison, R S, Gruber-Baldini, A L, Hebel, J R, Magaziner, J
Format: Article
Language:English
Subjects:
Activities of Daily Living
Affect - physiology
Age Factors
Aged
Aged, 80 and over
Clinical outcomes
Cognition - physiology
Confounding Factors (Epidemiology)
Continental Population Groups
Delirium - etiology
Depression - etiology
Depression - psychology
Disease
Female
Follow-Up Studies
Forecasting
Fractures
Hip Fractures - complications
Hip Fractures - psychology
Hip Fractures - surgery
Hip joint
Hospitalization
Humans
Impact analysis
Inpatient care
Length of Stay
Long-Term Care
Male
Medical diagnosis
Mental disorders
Older people
Pain - psychology
Patient Admission
Patient Discharge
Prognosis
Recovery of Function - physiology
Risk Factors
Sex Factors
Statistics as Topic
Survival Rate
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Hip fracture patients are at increased risk of confusion or delirium due to the trauma associated with the injury and the rapid progression to hospitalization and surgery, in addition to the pain and loss of function experienced. Hip fracture patients who develop delirium may require longer hospital stays, are more often discharged to long-term care, and have a generally poor prognosis for returning home or regaining function in activities of daily living (ADL). The present study examines the impact of delirium present on hospital admission in a sample of 682 non-demented, aged hip fracture patients residing in the community at the time of their fracture. In-hospital assessments designed to assess both prefracture and postfracture functioning, as well as follow-up interviews at 2, 6, 12, 18, and 24 months postfracture, were obtained from participants. Analyses indicate that baseline or admission delirium is an important prognostic predictor of poor long-term outcomes in persons without known cognitive impairment, after controlling for age, gender, race, comorbidity, and functional status. Delirium at admission (i.e., prior to surgery) was associated with poorer functioning in physical, cognitive, and affective domains at 6 months postfracture and slower rates of recovery. Impairment and delays in recovery may be further exacerbated by increased depressive symptoms in confused patients over time. Delirium on hospital admission was not a significant predictor of mortality after adjustment for confounding factors. The present findings further emphasize the significance of immediate detection and treatment of delirium in hip fracture patients to ameliorate the short and long-term effects of acute confusion on functional outcomes.
ISSN:1079-5006
1758-535X
DOI:10.1093/gerona/55.9.M527