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Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia
Lee HB, Mears SC, Rosenberg PB, Leoutsakos JM, Gottschalk A, Sieber FE.. Journal of the American Geriatrics Society, 2011-12-01
Topic: Risk, prevention and care in population studies
Objectives Based on a multifactorial model of delirium, to compare the types and magnitude of pre- and intraoperative predisposing factors for incident delirium in a stratified sample of individuals with and without preoperative dementia undergoing acute hip fracture repair. Design Prospective cohort study. Setting Academic medical center. Participants Four hundred twenty-five individuals with acute hip fracture and without delirium (mean age 80.2 ± 6.8, 73.2% female, 33.1% with probable dementia) admitted to a multidisciplinary hip fracture repair service. Measurements A research nurse assessed each participant for delirium based on the Confusion Assessment Method (CAM) before study enrollment and from the second postoperative day until hospital discharge. Results The incidence of delirium was higher in the group with probable dementia (56%) than in the group without dementia (26%) (P < .001). In the group without dementia (n = 284), age (odds ratio (OR) = 1.07, 95% CI = 1.02-1.13), male sex (OR = 2.81, 95% CI = 1.40-5.64), body mass index (OR = 0.92, 95% CI = 0.86-0.99), number of medical comorbidities (OR = 1.15, 95% CI = 1.01-1.32), and duration of surgery longer than 2 hours (OR = 2.53, 95% CI = 1.20-4.88) were independently associated with postoperative delirium. In the group with probable dementia, only the lag time from the emergency department to operating room was significantly associated (OR = 2.83, 95% CI = 1.24-2.25) with delirium. Conclusion Preoperative determination of dementia status is important for risk stratification for incident delirium after acute hip fracture repair surgery because types and magnitude of predisposing risk factors for postoperative delirium substantially differ based on preoperative dementia status.
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APA 7th
Lee, H. B., Mears, S. C., Rosenberg, P. B., Leoutsakos, J. M., Gottschalk, A., & Sieber, F. E. (2011). Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2011.03725.x
Vancouver
Lee HB, Mears SC, Rosenberg PB, Leoutsakos JM, Gottschalk A, Sieber FE. Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia. Journal of the American Geriatrics Society. 2011. doi:10.1111/j.1532-5415.2011.03725.x. PMID: 22188077.
BibTeX
@article{lee2011-22188077,
author = {Lee, H. B. and Mears, S. C. and Rosenberg, P. B. and Leoutsakos, J. M. and Gottschalk, A. and Sieber, F. E.},
title = {{Predisposing factors for postoperative delirium after hip fracture repair in individuals with and without dementia}},
journal = {Journal of the American Geriatrics Society},
year = {2011},
doi = {10.1111/j.1532-5415.2011.03725.x},
pmid = {22188077},
url = {https://doi.org/10.1111/j.1532-5415.2011.03725.x}
}
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Key findings
- Results The incidence of delirium was higher in the group with probable dementia (56%) than in the group without dementia (26%) (P < .001).
- In the group without dementia (n = 284), age (odds ratio (OR) = 1.07, 95% CI = 1.02-1.13), male sex (OR = 2.81, 95% CI = 1.40-5.64), body mass index (OR = 0.92, 95% CI = 0.86-0.99), number of medical comorbidities (OR = 1.15, 95% CI = 1.01-1.32), and duration of surgery longer than 2 hours (OR = 2.53, 95% CI = 1.20-4.88) were independently associated with postoperative delirium.
- In the group with probable dementia, only the lag time from the emergency department to operating room was significantly associated (OR = 2.83, 95% CI = 1.24-2.25) with delirium.
Study details
- Study designcohort study
- Participants284
- Effect size73.2%; 33.1%; OR = 2.81
- Evidence strengthModerate
How this study scored 66/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 38 of the 58 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 2 / 4 | 284 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22188077) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 38 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 58 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
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