Postoperative delirium after major orthopedic surgery

doi:10.5312/wjo.v11.i2.90

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Feb 18, 2020 (publication date) through Feb 4, 2025

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Orthop. Feb 18, 2020; 11(2): 90-106
Published online Feb 18, 2020. doi: 10.5312/wjo.v11.i2.90

Table 2 Patient demographics and study population

	POD (Mean +/- SD or n, %), n = 959	Non-POD (Mean +/- SD or n, %), n = 77533	P value
Age, yr	72.7+/-12.9	62.3+/-14.1	< 0.001^a
≥ 70	610 (63.6)	24038 (31.0)	< 0.001^a
Male	389 (40.6)	34777 (44.9)	0.008^a
BMI	28.2+/-6.2	28.0+/-6.1	0.003^a
Procedure type			< 0.001^a
THA	161 (16.8)	19753 (25.5)
TKA	249 (26.0)	20106 (25.9)
Bilateral THA	3 (0.3)	853 (1.1)
Bilateral TKA	29 (3.0)	2337 (3.0)
Spine fusions	140 (14.6)	4135 (5.3)
Other spine procedures	126 (13.1)	6587 (8.5)
Other procedures	251 (26.2)	23762 (30.7)
Trauma			< 0.001^a
Fracture of femur/pelvis	57 (5.9)	731 (0.9)
Other trauma	30 (3.1)	2607 (3.4)
No trauma	872 (90.9)	74195 (95.7)
Length of stay	6.0+/-7.5	3.0+/-3.2	< 0.001^a
Latest creatinine before surgery			< 0.001^a
< 1.2 mg/dL	825 (86.0)	71048 (91.6)
1.2-2.0 mg/dL	123 (12.8)	6229 (8.0)
> 2.0 mg/d	11 (1.2)	256 (0.3)
Preoperative hyponatremia			< 0.001^a
Yes	367 (38.3)	21290 (27.5)
No	591 (61.6)	56190 (72.5)
Missing	1 (0.1)	53 (0.07)
Postoperative thiamine order			< 0.001^a
Yes	119 (12.4)	1390 (1.8)
No	839 (87.5)	76122 (98.2)
Missing	1 (0.1)	21 (0.03)
Atrial fibrillation (present on admission)	130 (13.6)	3815 (4.9)	< 0.001^a
Pressure ulcers (present on admission)	23 (2.4)	323 (0.42)	< 0.001^a
Opioid dependence or long-term use	29 (6.2)	1245 (1.6)	< 0.001^a
Psychiatric disease (present on admission)	356 (37.1)	16716 (21.6)	< 0.001^a
Anesthesia type			< 0.001^a
General	344 (35.9)	16356 (21.9)
Other	578 (60.3)	56067 (72.3)
Missing	37 (3.9)	4510 (5.8)
Patient-controlled analgesia			< 0.001^a
Epidural	413 (43.1)	40991 (52.9)
IV	441 (46.0)	22458 (29.0)
Peripheral nerve infusion	11 (1.2)	949 (1.2)
Missing	94 (9.8)	13135 (16.9)
Received diazepam			< 0.001^a
Yes	98 (10.2)	3135 (4.0)
No	860 (89.7)	74377 (95.9)
Missing	1 (0.1)	21 (0.03)
CT, MRI or both performed			< 0.001^a
Yes	872 (90.9)	64838 (83.6)
No	86 (9.0)	12674 (16.4)
Missing	1 (0.1)	21 (0.03)
ASA score			< 0.001^a
1	7 (0.73)	4933 (6.4)
2	477 (49.7)	53801 (69.4)
≥ 3	438 (45.7)	14274 (18.4)
Missing	37 (3.9)	4525 (5.8)

^aP < 0.05. POD: Postoperative delirium; THA: Total hip arthroplasty; TKA: Total knee arthroplasty; ASA: American society of anesthesiologists; BMI: Body mass index; SD: Standard deviation; CT: Computed tomography; MRI: Magnetic resonance imaging.

Citation: Urban MK, Sasaki M, Schmucker AM, Magid SK. Postoperative delirium after major orthopedic surgery. World J Orthop 2020; 11(2): 90-106
URL: https://www.wjgnet.com/2218-5836/full/v11/i2/90.htm
DOI: https://dx.doi.org/10.5312/wjo.v11.i2.90