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Published in: Osteoporosis International 2/2020

01-02-2020 | Original Article

Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis

Authors: J. Bai, Y. Liang, P. Zhang, X. Liang, J. He, J. Wang, Y. Wang

Published in: Osteoporosis International | Issue 2/2020

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Abstract

Introduction

Postoperative delirium (POD) is a common complication in elderly surgical patients. Patients undergoing hip fractures surgery who are often characterized by advanced age could be particularly prone to suffering POD. We performed a meta-analysis to assess the association between POD and mortality in elderly patients undergoing hip fractures surgery.

Summary

This meta-analysis included twenty-one cohort studies, and the pooled outcomes demonstrated that approximated one-fourth of patients undergoing hipfracture surgery would develop POD, and delirium increased the mortality in these patients.

Methods

We searched PubMed, Embase, Web of Science, and Scopus for studies that investigated the effect of POD on mortality in elderly patients undergoing hip fracture surgery. Two reviewers independently selected studies, assessed quality, and extracted data. Statistical analyses were performed by STATA 14.0 and RevMan 5.3. Risk ratios (RRs) with 95% confidence intervals (CIs) were derived using random or fixed-effects model.

Results

Twenty-one cohort studies enrolling a total of 6288 patients were included, and the pooled prevalence (95% CI) of POD was 28% (23–34%). POD was associated with an increase in perioperative mortality (30-day or in-hospital mortality) [12 studies, 3123 patients, relative risk (RR) (95% CI) 2.79 (1.97–3.93)], 6-month mortality [6 studies, 1673 patients, 2.51 (1.99–3.16)], 1-year mortality [6 studies, 1896 patients, 1.98 (1.62–2.41)], and more than 1-year mortality [8 studies, 1926 patients, 2.06 (1.60–2.64)].

Conclusions

Our meta-analysis demonstrated that approximated one-fourth of patients undergoing hip fracture surgery would develop POD, and delirium increased the short-term and long-term mortality in these patients.
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Metadata
Title
Association between postoperative delirium and mortality in elderly patients undergoing hip fractures surgery: a meta-analysis
Authors
J. Bai
Y. Liang
P. Zhang
X. Liang
J. He
J. Wang
Y. Wang
Publication date
01-02-2020
Publisher
Springer London
Published in
Osteoporosis International / Issue 2/2020
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-019-05172-7

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