Effect of early postoperative delirium on outcomes in elderly patients undergoing joint replacement

Abstract

Objective To evaluate the effect of early postoperative delirium on outcomes in elderly patients undergoing joint replacement. Methods Elderly patients, aged≥60 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective hip or knee joint replacement, were divided into delirium group and non-delirium group according to whether the patients developed postoperative delirium.The case-matching criteria was set up with difference in age less than 5 yr and difference in Charlson comorbidity index less than 2 and with a ratio of 1∶4 for match.The development of complications was recorded within 28 days after operation.Complications happened after delirium was recorded in delirium group. Results There were 53 cases in delirium group and 212 cases in non-delirium group.There was no significant difference in preoperative baseline data or intraoperative variables between two groups (P>0.05). Compared with non-delirium group, the total incidence of postoperative complications was significantly increased, the incidence of postoperative cognitive dysfunction, cardiovascular complications, pulmonary complications and deep venous thrombosis was increased, and the length of hospitalization was prolonged in delirium group (P<0.05). Conclusion Early postoperative delirium is not helpful for outcomes in elderly patients undergoing joint replacement. Key words: Delirium; Arthroplasty, replacement; Aged; Prognosis