Inzidenz und Risikofaktoren eines Delirs nach Hüftoperation

 

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Zusammenfassung

Anliegen: Mit der Studie wird die Inzidenz postoperativer Delirien bestimmt. Um Hinweise auf Präventionsmöglichkeiten zu erhalten, wird die Assoziation zwischen Inzidenz und Risikofaktoren geprüft. Methode: 200 konsekutive Patienten über 60 Jahre wurden prospektiv mit einem standardisierten Untersuchungsinstrumentarium präoperativ und täglich postoperativ untersucht. Die Assoziation zwischen Risikofaktoren und Delir wurde mittels multipler logistischer Regression analysiert. Ergebnisse: Bei 20,5 % der untersuchten Patienten trat postoperativ ein Delir auf. Bedeutsamste Risikofaktoren waren höheres Alter, geringere präoperative kognitive Leistung und somatische Komorbidität. Schlussfolgerungen: Die Resultate bestätigen eine hohe Delirinzidenz bei älteren Patienten. Es konnten nur wenige Hinweise auf modifizierbare Risikofaktoren gefunden werden.

Abstract

Objective: Postoperative delirium is common among elderly hip surgery patients. The objective of the current study was to determine the incidence of delirious states and to identify possible risk factors. Method: The sample consisted of 200 consecutive patients, age 60 years and older, who underwent hip surgery because of acute hip fracture or elective hip replacement. Patients were prospectively assessed preoperatively and on a daily basis postoperatively using the Confusion Assessment Method (CAM). Associations between risk factors and delirium were analysed by means of multiple logistic regression models. Results: 20.5 % of the sample were diagnosed with postoperative delirium. Statistically significant risk factors for the development of delirium were higher age, lower preoperative cognitive test performance and severe physical comorbidity. Some other putative risk factors tended to be associated with postoperative delirium, but failed to reach statistical significance. Conclusions: The study confirmed a high incidence of delirium among hip surgery patients. Apart from established risk factors like old age, low cognitive test performance, and comorbidity, no other significant risk factors could be identified.

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Dr. Horst Bickel

Klinik und Poliklinik für Psychiatrie und Psychotherapie der TU München · Klinikum rechts der Isar

Ismaninger Straße 22

81675 München

Email: h.bickel@lrz.tum.de