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Reduce the postoperative delirium risk

Increased risk for postoperative delirium has been documented in elderly patients undergoing hip fracture repair.1

Hip Fracture Repair Incidence

High, low, and mean incidence of postoperative delirium in hip fracture repair.

CLINICAL EVIDENCE
Study Procedure Incidence of Delirium Elderly? N
Gottschalk 20152 Hip fracture repair 32.90% Yes 459
Guo 20163 Hip fracture repair 21% Yes 572
Lee 20114 Hip fracture repair 30.20% Yes 232
Mosk 20175 Hip fracture repair 35% Yes 566
Yang 20176 Hip fracture repair 24% Yes 5364
Zywiel 20151 Hip fracture repair 48% Yes 242

CLINICAL EVIDENCE

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REDUCING THE RISK OF POSTOPERATIVE DELIRIUM VIA BIS™-GUIDED ANESTHESIA

Sieber 2010

Elderly patients undergoing hip fracture repair (n=114) under propofol sedation with spinal anesthesia were randomized to receive either deep (BIS™ index values≈50) or light (BIS™ index values ≥80) sedition.9  Postoperative delirium was assessed after the second day postoperatively.   The light sedation group had a 50% reduction in delirium compared to the deep sedation group.  

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  • 1. Zywiel MG, Hurley RT, Perruccio AV, Hancock-Howard RL, Coyte PC, Rampersaud YR. Health economic implications of perioperative delirium in older patients after surgery for a fragility hip fracture. J Bone Joint Surg Am. 2015;97(10):829-836.
  • 2. Gottschalk A, Hubbs J, Vikani AR, Gottschalk LB, Sieber FE. The Impact of Incident Postoperative Delirium on Survival of Elderly Patients After Surgery for Hip Fracture Repair. Anesth Analg. 2015;121(5):1336-1343.
  • 3. Guo Y, Jia P, Zhang J, Wang X, Jiang H, Jiang W. Prevalence and risk factors of postoperative delirium in elderly hip fracture patients. J Int Med Res. 2016;44(2):317-327.
  • 4. Lee KH, Ha YC, Lee YK, Kang H, Koo KH. Frequency, risk factors, and prognosis of prolonged delirium in elderly patients after hip fracture surgery. Clin Orthop Relat Res. 2011;469(9):2612-2620.
  • 5. Mosk CA, Mus M, Vroemen JP, et al. Dementia and delirium, the outcomes in elderly hip fracture patients. Clin Interv Aging. 2017;12:421-430.
  • 6. Yang Y, Zhao X, Dong T, Yang Z, Zhang Q, Zhang Y. Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis. Aging Clin Exp Res. 2017;29(2):115-126.
  • 7. Kat MG, Vreeswijk R, de Jonghe JF, et al. Long-term cognitive outcome of delirium in elderly hip surgery patients. A prospective matched controlled study over two and a half years. Dement Geriatr Cogn Disord. 2008;26(1):1-8.
  • 8. Bickel H, Gradinger R, Kochs E, Forstl H. High risk of cognitive and functional decline after postoperative delirium. A three-year prospective study. Dement Geriatr Cogn Disord. 2008;26(1):26-31.
  • 9. Sieber FE, Zakriya KJ, Gottschalk A, et al. Sedation depth during spinal anesthesia and the development of postoperative delirium in elderly patients undergoing hip fracture repair. Mayo Clin Proc. 2010;85(1):18-26.
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