The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model

Abstract Objective This study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors. Methods This retrospective observational study prospectively included elderly patients with hip fractures w...

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Main Authors: XiaoLing Chen, Yixin Huang, Fengxiang Chen, Xiaole Jiang, Dongze Lin, Fengfei Lin
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-025-06114-2
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author XiaoLing Chen
Yixin Huang
Fengxiang Chen
Xiaole Jiang
Dongze Lin
Fengfei Lin
author_facet XiaoLing Chen
Yixin Huang
Fengxiang Chen
Xiaole Jiang
Dongze Lin
Fengfei Lin
author_sort XiaoLing Chen
collection DOAJ
description Abstract Objective This study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors. Methods This retrospective observational study prospectively included elderly patients with hip fractures who were admitted to the Trauma Department of our hospital from November 2024 to May 2025, managed under the Unaccompanied-Care nursing model, and underwent surgical treatment. We retrospectively analyzed the patients’ baseline data, blood indicators, and surgery-related data for data analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with delirium in the perioperative period. Results A total of 138 patients were included, of whom 35 (25.36%) developed delirium. The incidence of delirium was 2.17% (3 cases) preoperatively, 6.52% (9 cases) within 6 h postoperatively, 10.14% (14 cases) within 1 day postoperatively, 4.35% (6 cases) on postoperative day 2, and 2.17% (3 cases) on postoperative day 3. Multivariate analysis showed that mild visual impairment (OR = 15.74, 95% CI: 2.53–97.29, p = 0.003), severe visual impairment (OR = 9.68, 95% CI: 5.20–18.30, p = 0.002); mild hearing impairment (OR = 7.09, 95% CI: 1.23–40.74, p = 0.028), moderate hearing impairment (OR = 6.43, 95% CI: 1.80–51.41, p = 0.031), severe hearing impairment (OR = 16.59, 95% CI: 1.76–156.61, p = 0.014), and hemoglobin (OR = 1.95, 95% CI: 1.91–5.99, p = 0.037) were independent risk factors for delirium. Conclusion Although the Unaccompanied-Care model shows specific effects in the nursing of elderly patients with hip fractures, the incidence of delirium remains high. Sensory dysfunction and low hemoglobin levels are important risk factors for delirium.
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spelling doaj-art-5003c86ea97a42c1ae9be20c7f0408dc2025-08-20T03:46:25ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-0120111310.1186/s13018-025-06114-2The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care modelXiaoLing Chen0Yixin Huang1Fengxiang Chen2Xiaole Jiang3Dongze Lin4Fengfei Lin5School of Clinical Medicine, Fujian Medical UniversitySchool of Clinical Medicine, Fujian Medical UniversitySchool of Clinical Medicine, Fujian Medical UniversitySchool of Clinical Medicine, Fujian Medical UniversitySchool of Clinical Medicine, Fujian Medical UniversitySchool of Clinical Medicine, Fujian Medical UniversityAbstract Objective This study aims to assess the incidence of postoperative delirium in elderly patients with hip fractures under the Unaccompanied- Care model and to explore its risk factors. Methods This retrospective observational study prospectively included elderly patients with hip fractures who were admitted to the Trauma Department of our hospital from November 2024 to May 2025, managed under the Unaccompanied-Care nursing model, and underwent surgical treatment. We retrospectively analyzed the patients’ baseline data, blood indicators, and surgery-related data for data analysis. Univariate and multivariate logistic regression analyses were used to identify risk factors associated with delirium in the perioperative period. Results A total of 138 patients were included, of whom 35 (25.36%) developed delirium. The incidence of delirium was 2.17% (3 cases) preoperatively, 6.52% (9 cases) within 6 h postoperatively, 10.14% (14 cases) within 1 day postoperatively, 4.35% (6 cases) on postoperative day 2, and 2.17% (3 cases) on postoperative day 3. Multivariate analysis showed that mild visual impairment (OR = 15.74, 95% CI: 2.53–97.29, p = 0.003), severe visual impairment (OR = 9.68, 95% CI: 5.20–18.30, p = 0.002); mild hearing impairment (OR = 7.09, 95% CI: 1.23–40.74, p = 0.028), moderate hearing impairment (OR = 6.43, 95% CI: 1.80–51.41, p = 0.031), severe hearing impairment (OR = 16.59, 95% CI: 1.76–156.61, p = 0.014), and hemoglobin (OR = 1.95, 95% CI: 1.91–5.99, p = 0.037) were independent risk factors for delirium. Conclusion Although the Unaccompanied-Care model shows specific effects in the nursing of elderly patients with hip fractures, the incidence of delirium remains high. Sensory dysfunction and low hemoglobin levels are important risk factors for delirium.https://doi.org/10.1186/s13018-025-06114-2Unaccompanied CareDeliriumHip fracturesRisk factors
spellingShingle XiaoLing Chen
Yixin Huang
Fengxiang Chen
Xiaole Jiang
Dongze Lin
Fengfei Lin
The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
Journal of Orthopaedic Surgery and Research
Unaccompanied Care
Delirium
Hip fractures
Risk factors
title The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
title_full The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
title_fullStr The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
title_full_unstemmed The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
title_short The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
title_sort incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the unaccompanied care model
topic Unaccompanied Care
Delirium
Hip fractures
Risk factors
url https://doi.org/10.1186/s13018-025-06114-2
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