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©The Author(s) 2020.
World J Orthop. Feb 18, 2020; 11(2): 90-106
Published online Feb 18, 2020. doi: 10.5312/wjo.v11.i2.90
Published online Feb 18, 2020. doi: 10.5312/wjo.v11.i2.90
Table 6 Perioperative risk factors and adjusted association with postoperative delirium by procedure
THAOR (95%CI), n = 18276 | THA P value | TKAOR (95%CI), n = 19987 | TKA P value | SFOR (95%CI), n = 4183 | SF P value | |
Age, yr | ||||||
≥ 70 vs < 70 | 4.9 (3.0, 7.9) | < 0.001a | 2.16 (1.58, 2.94) | < 0.001a | - | - |
≥ 65 vs < 65 | - | - | - | - | 2.76 (1.79, 4.25) | < 0.001a |
Male | 0.90 (0.60, 1.35) | 0.62 | 0.82 (0.60, 1.12) | 0.21 | 0.73 (0.48, 1.10) | 0.13 |
BMI | 0.94 (0.90, 0.98) | 0.004a | 0.99 (0.96, 1.02) | 0.37 | 0.99 (0.95, 1.02) | 0.46 |
Latest creatinine value before surgery | ||||||
1.2-2.0 mg/dL vs < 1.2 mg/dL | 1.77 (1.05, 3.00) | 0.03a | 0.79 (0.49, 1.27) | 0.32 | 1.40 (0.73, 2.68) | 0.31 |
> 2.0 mg/dL vs < 1.2 mg/dL | 4.08 (1.06, 15.66) | 0.04a | 1.39 (0.46, 4.20) | 0.56 | 2.26 (0.20, 26.24) | 0.51 |
Preoperative hyponatremia | 2.36 (1.54, 3.64) | < 0.001a | 1.25 (0.87, 1.79) | 0.23 | 1.24 (0.82, 1.88) | 0.31 |
PCA route | ||||||
IV vs Epidural | 1.98 (1.19, 3.28) | 0.008a | 1.26 (0.83, 1.92) | 0.27 | - | - |
Peripheral nerve infusion vs Epidural | - | - | 0.93 (0.47, 1.86) | 0.85 | - | - |
Postoperative thiamine order | 5.05 (2.72, 9.37) | < 0.001a | 6.40 (4.00, 10.26) | <0.001a | 6.64 (3.72, 11.85) | <0.001a |
ASA Score | ||||||
2 vs 1 | - | - | 1.91 (0.26, 13.88) | 0.52 | 1.90 (0.25, 14.19) | 0.53 |
> 3 vs 1 | - | - | 3.63 (0.49, 26.74) | 0.21 | 2.38 (0.31, 18.46) | 0.41 |
≥ 3 vs 2 | 2.01 (1.33, 3.05) | < 0.001a | - | - | - | - |
Anesthesia type | ||||||
Other vs general | 2.92 (0.66, 12.85) | 0.16 | 0.89 (0.43, 1.82) | 0.74 | - | - |
Surgery length | 1.00 (1.00, 1.01) | 0.10 | 1.00 (0.99, 1.01) | 0.55 | 1.00 (1.00, 1.00) | <0.001a |
Atrial fibrillation, present on admission | 0.97 (0.53, 1.77) | 0.91 | 1.93 (1.32, 2.81) | <0.001a | 2.19 (1.09, 4.41) | 0.03a |
Pressure ulcers, present on admission | 0.65 (0.08, 5.05) | 0.68 | - | - | 7.56 (1.89, 30.24) | 0.004a |
Opioid dependence or long-term use | 7.11 (3.26, 15.51) | < 0.001a | 2.98 (1.38, 6.41) | 0.005a | 1.88 (0.91, 3.90) | 0.09 |
Parenteral diazepam | 5.05 (1.5, 16.97) | 0.009a | 4.40 (1.52, 12.75) | 0.007a | 2.17 (1.19, 3.97) | 0.01a |
Elixhauser comorbidity | ||||||
Deficiency anemias | 1.64 (0.74, 3.63) | 0.22 | 1.10 (0.57, 2.11) | 0.78 | 1.11 (0.42, 2.93) | 0.83 |
Congestive heart failure | 2.35 (0.93, 5.96) | 0.07 | 1.59 (0.74, 3.38) | 0.23 | 1.54 (0.39, 6.11) | 0.54 |
Rheumatoid arthritis/collagen vascular diseases | 1.06 (0.45, 2.51) | 0.900 | 0.35 (0.13, 0.94) | 0.04a | 1.02 (0.49, 2.13) | 0.95 |
Chronic pulmonary disease | 1.13 (0.67, 1.92) | 0.64 | 0.84 (0.55, 1.28) | 0.41 | 1.06 (0.65, 1.73) | 0.82 |
Coagulopathy | 1.32 (0.39, 4.53) | 0.66 | 1.60 (0.70, 3.62) | 0.26 | 2.80 (1.05, 7.50) | 0.04a |
Depression | 1.70 (1.05, 2.75) | 0.03a | 1.47 (1.02, 2.11) | 0.04a | 2.61 (1.73, 3.92) | <0.001a |
Diabetes w/o chronic complications | 1.54 (0.90, 2.64) | 0.12 | 1.90 (1.36, 2.66) | < 0.001a | 1.54 (0.92, 2.58) | 0.10 |
Diabetes w chronic complications | 2.05 (0.45, 9.23) | 0.35 | 1.77 (0.68, 4.58) | 0.24 | 3.34 (1.02, 10.91) | 0.046a |
Hypertension | 1.62 (1.06, 2.48) | 0.03a | 1.21 (0.59, 1.64) | 0.23 | 1.00 (0.66, 1.51) | 0.99 |
Hypothyroidism | 1.01 (0.61, 1.66) | 0.98 | 1.46 (1.06, 2.02) | 0.02a | 1.07 (0.65, 1.76) | 0.80 |
Liver disease | 0.41 (0.05, 3.22) | 0.40 | 0.70 (0.16, 3.07) | 0.63 | 0.71 (0.15, 3.30) | 0.66 |
Lymphoma | 1.33 (0.25, 7.20) | 0.74 | - | - | - | - |
Fluid and electrolyte disorders | 0.31 (0.04, 2.43) | 0.26 | 1.41 (0.44, 4.56) | 0.57 | 1.14 (0.36, 3.63) | 0.82 |
Other neurological disorders | 2.04 (0.98. 4.27) | 0.06 | 2.79 (1.69, 4.60) | < 0.001a | 2.14 (1.10, 4.14) | 0.02a |
Obesity | 1.06 (0.53, 2.12) | 0.88 | 0.79 (0.53, 1.19) | 0.27 | 1.56 (0.90, 2.69) | 0.11 |
Peripheral vascular disorders | 1.20 (0.47, 3.10) | 0.70 | 1.40 (0.62, 3.16) | 0.42 | 1.68 (0.64, 4.42) | 0.30 |
Psychoses | 2.52 (0.81, 7.90) | 0.11 | 6.39 (3.51, 11.62) | < 0.001a | 4.95 (2.38, 10.28) | <0.001a |
Pulmonary circulation disorders | 1.20 (0.47, 3.10) | 0.70 | 1.69 (0.89, 3.23) | 0.11 | 1.57 (0.51, 4.88) | 0.44 |
Renal failure | 0.94 (0.41, 2.15) | 0.88 | 2.32 (1.31, 4.11) | 0.004a | 0.97 (0.39, 2.45) | 0.95 |
Solid tumor w/o metastasis | - | - | 1.42 (0.31, 6.45) | 0.65 | - | - |
Valvular disease | 1.08 (0.59, 1.97) | 0.80 | 1.23 (0.79, 1.92) | 0.37 | 1.17 (0.61, 2.26) | 0.63 |
Weight loss | 0.61 (0.05, 7.46) | 0.70 | 7.14 (0.62, 82.11) | 0.11 | - | - |
- 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