Background and aims Cognitive dysfunction (delirium) is a frequent and undesirable condition in elderly patients suffering poor autonomy. We tested the hypothesis that a poor autonomy in daily life activities (ADLA) and (delirium) may lead to an increased incidence of major in-hospital complications in elderly patients with hip fracture.
Methods After ethical committee approval, we retrospectively investigated all patients scheduled for hip-fracture surgery screened for a multicenter RCT (NCT03092466) testing the effects of early femoral block on the incidence of delirium in the elderly. a logistic regression model was built using proportional odds with 95% CI taking a simplified Clavien Dindo score with 3 categories as the dependent variable: none, minor and major complications. Three predictive variables were assessed: age, ADLA using a simplified Katz score (5–6 = autonomous, <5 = dependent) and perioperative delirium. No further variable selection process was run. p < 0.05 was considered significant.
Results Between September 2018 and February 2019, 229 patients admitted in a single-centre (AUSL - IRCCS Reggio Emilia) were collected: 102 (45%) resulted ‘dependent’, 101 (44%) developed delirium, 81 (36%) reported no complications, 112 (49%) reported minor complication, while 35 (15%) patients had major complication requiring more-than-pharmacological treatment. the regression model unveiled significant correlations of all the predictive variables, as shown in table 1. table 2 shows the descriptive statistics of our sample.
Conclusions This retrospective preliminary analysis suggest that age, poor autonomy and perioperative delirium are independent risk factors for major complications in elderly undergoing hip fracture surgery.
This study is sponsored by ‘ESRA research grant 2017’ (NCT03092466).
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