Article ; Online: Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study.
Aging clinical and experimental research
2023 Volume 35, Issue 11, Page(s) 2499–2506
Abstract: Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF).: Methods: Multicenter prospective observational study ... ...
| Abstract | Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods: Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. Results: 984 patients (median age 84 years, IQR = 79-89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19-2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02-3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85-7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21-4.66, p < 0.001). Conclusions: POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients. |
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| MeSH term(s) | Humans ; Aged, 80 and over ; Frailty/complications ; Emergence Delirium ; Functional Status ; Delirium ; Prospective Studies ; Hip Fractures/surgery ; Risk Factors |
| Language | English |
| Publishing date | 2023-08-05 |
| Publishing country | Germany |
| Document type | Observational Study ; Multicenter Study ; Journal Article |
| ZDB-ID | 2104785-6 |
| ISSN | 1720-8319 ; 1594-0667 |
| ISSN (online) | 1720-8319 |
| ISSN | 1594-0667 |
| DOI | 10.1007/s40520-023-02522-8 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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