Factors analysis and prognostic impact of delirium after intertrochanteric fracture surgery
Objective To explore the factors associated with delirium occurrence following surgical treatment for intertrochanteric fractures of the femur and its impact on prognosis.Methods A retrospective analysis was conducted on 41 patients who developed postoperative delirium after surgical treatment for femoral intertrochanteric fractures at Taihe County People's Hospital from July 2021 to December 2022.Additionally,41 patients without postoperative delirium during the same period were selected.According to whether postoperative delirium occurred,they were divided into delirium group and non delirium group.General and clinical data were collected for both groups,and multivariate logistic regression analysis to analyze the factors and prognostic effects of postoperative delirium in patients with intertrochanteric fractures of the femur.Results Comparing the general data of the two groups,it was found that there were statistically significant differences in HAMD,HAMA score,PaO2,injury to surgery time,age,surgery time,and comorbidities between the delirium group and the non delirium group(P<0.05).Univariate analysis of postoperative delirium found that there were statistically significant differences between the two groups in preoperative albumin,analgesic pump,intraoperative bleeding,days from fracture to surgery,intraoperative hypoxemia,and whether midazolam was used(P<0.05).Multivariate analysis showed that age,preoperative serum albumin levels,and intraoperative hypoxemia were significantly associated with postoperative delirium and were independent risk factors(P<0.05).There was a significant difference between the two groups in terms of adverse cardiac events and pulmonary infections(P<0.05),respectively.However,there was no significant difference between the two groups in terms of cerebrovascular events,gastrointestinal bleeding,and other complications(P>0.05).Conclusion Age,anesthesia method,preoperative albumin levels,intraoperative hypoxemia,and postoperative analgesia(midazolam use)are important factors influencing postoperative delirium in intertrochanteric fractures.Close monitoring of vital signs during perioperative care is essencial,particularly for high-risk elderly patients.Strengthening postoperative delirium risk assessment and implementing preventive measures can help improve patient patient prognosis and overall quality care.
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