Preoperative Risk Factors for Subsyndromal Delirium in Older Adults Who Undergo Joint Replacement Surgery.
Dawn L Denny, Glenda Lindseth
PMID 29189623WHAT IT FOUND
After joint replacement, 36 of 53 older adults had one or two delirium symptoms in the first 3 days.
A fall in the past 6 months and longer preoperative fasting were linked to more symptoms; comorbidity and cognitive scores were not.
Key findings
01Subsyndromal delirium was common after joint replacement: 36 of 53 participants developed it on at least one of the first 3 postoperative days.
02A fall in the previous 6 months was associated with more delirium symptoms over the first 72 hours.
03Longer preoperative fasting was associated with more delirium symptoms on postoperative day 3.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was observational, so it can show associations but cannot prove that falls or fasting caused delirium. The sample was small and not diverse: 53 participants, 52 Caucasian and one Native American, from one rural hospital. Only one researcher assessed delirium symptoms, and the study could not check whether different assessors would get the same result. Follow-up stopped at postoperative day 3, so later delirium or recovery was not measured. Missing data were replaced with an imputation method, which can affect estimates. The study examined only a selected set of preoperative factors, not all possible causes of delirium symptoms.
Declared interests
The authors reported no conflicts of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude that longer preoperative fasting or a recent fall caused delirium. This was an observational study of 53 patients, and it only showed associations through postoperative day 3; it did not test whether changing fasting time or preventing falls reduces delirium.