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Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis
Smith TO, Cooper A, Peryer G, Griffiths R, Fox C, Cross J.. International journal of geriatric psychiatry, 2017-01-17
Topic: Risk, prevention and care in population studies
Plain-language summary
Objective Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. Methods Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery. Pooled odds ratio (OR) and mean difference of those who experienced delirium compared to those who did not were calculated for each variable. Evidence was assessed using the Downs and Black appraisal tool and interpreted using the GRADE approach. Results A total of 6704 people (2090 people with post-operative delirium) from 32 studies were analysed. There was moderate evidence of nearly a two-times greater probability of post-operative delirium for those aged 80 years and over (OR: 1.77; 95% CI: 1.09, 2.87), whether patients lived in a care institution pre-admission (OR: 2.65; 95% CI: 1.79, 3.92), and a six-times greater probability of developing post-operative delirium with a pre-admission diagnosis of dementia (OR: 6.07, 95% CI: 4.84, 7.62). There was no association with intra-operative variables and probability of delirium. Conclusion Clinicians treating people with a hip fracture should be vigilant towards post-operative delirium if their patients are older, have pre-existing cognitive impairment and poorer overall general health. This is also the case for those who experience post-operative complications such as pneumonia or a urinary tract infection. Copyright © 2017 John Wiley & Sons, Ltd.
What this study adds
Evidence grade: Low
This is a pooled review of 6,704 participants. This review found that older age, living in a care institution before admission, and a pre-admission diagnosis of dementia were linked to a higher probability of post-operative delirium after hip fracture surgery. Reported effect size: OR: 1.77; OR: 2.65; OR: 6.07.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Smith, T. O., Cooper, A., Peryer, G., Griffiths, R., Fox, C., & Cross, J. (2017). Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. International journal of geriatric psychiatry. https://doi.org/10.1002/gps.4655
Vancouver
Smith TO, Cooper A, Peryer G, Griffiths R, Fox C, Cross J. Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. International journal of geriatric psychiatry. 2017. doi:10.1002/gps.4655. PMID: 28093812.
BibTeX
@article{smith2017-28093812,
author = {Smith, T. O. and Cooper, A. and Peryer, G. and Griffiths, R. and Fox, C. and Cross, J.},
title = {{Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis}},
journal = {International journal of geriatric psychiatry},
year = {2017},
doi = {10.1002/gps.4655},
pmid = {28093812},
url = {https://doi.org/10.1002/gps.4655}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery.
- Pooled odds ratio (OR) and mean difference of those who experienced delirium compared to those who did not were calculated for each variable.
- Results A total of 6704 people (2090 people with post-operative delirium) from 32 studies were analysed.
- Conclusion Clinicians treating people with a hip fracture should be vigilant towards post-operative delirium if their patients are older, have pre-existing cognitive impairment and poorer overall general health.
Why it matters
This review found that older age, living in a care institution before admission, and a pre-admission diagnosis of dementia were linked to a higher probability of post-operative delirium after hip fracture surgery. It helps clinicians identify patients at risk but does not test any treatment, cure, or prevention for Alzheimer's disease.
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Study details
- Participants6,704
- Effect sizeOR: 1.77; OR: 2.65; OR: 6.07
- Evidence strengthLow
How this study scored 64/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of geriatric psychiatry) |
| Journal's citation record | 2 / 4 | International Journal of Geriatric Psychiatry: journal h-index 190 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies (from PubMed type “Meta-Analysis”) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 6,704 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | A review of other studies — randomization is not credited here |
| Times cited | 5 / 7 | Cited 142 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.9 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 3 / 6 | Cited 3.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 30 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Jane Cross: h-index 21 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of East Anglia: institution h-index 759 (OpenAlex) |
| Multicenter collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28093812) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/gps.4655
- PubMed: 28093812
- Original source →
- Free full text: UEA Digital Repository (University of East Anglia) →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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