Impact of delirium on short-term outcomes in hip fracture patients under a program of approach to delirium

Abstract

Aim:We aimed to investigate the impact of delirium on short-term outcomes in hip fracturepatients. Special attention was given to patients with delirium and dementia.Methods:A prospective observational cohort study was carried out in hip fracture patientsaged≥70 years who were admitted to a hospital unit where a multicomponents approach todelirium is established for all patients. Our population was split into delirium (n= 212) andnon-delirium cohort (n= 171) according to the Confusion Assessment Method. Patients witha previous diagnosis of dementia in an outpatient appointment were also assessed within thedelirium cohort. The utility of the rehabilitation was measured with the Absolute FunctionalGain index.Results:A total of 383 patients were entered into the study. The median age was 86 years,and most patients were women (78.8%). Delirium patients were older, presented a lower pre-vious Barthel Index (BI), had higher rates of dementia and came more frequently from nursinghomes. Comparative analysis did not show differences in mortality, complications, length ofstay or walking ability between the cohorts. However, lower BI on discharge, lower AbsoluteFunctional Gain and the presence of nosocomial infections were found more frequently inthe delirium cohort. In multivariate analysis, only the BI on discharge (P= 0.010) was lower indelirium patients. Within the delirium cohort, those suffering from dementia had worse BI ondischarge (P= 0.017) and lower Absolute Functional Gain (P= 0.019).Conclusions:Delirium was not associated with mortality, walking ability, length of stay andclinical complications in hip fracture patients. BI on discharge was the only short-term out-come affected. In the delirium cohort, those suffering from dementia showed worse rehabili-tation results.