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This study investigated upon the different risk factors that may be involved in delirium formation after total knee arthroplasty in the geriatric population.
Delirium is a well-known complication following surgery in
the geriatric population. Patients with a higher
average age and a larger number of bilateral TKA were considered for this
analysis. Occurrence of post-operative delirium following TKA was found to be 6.5%
with no difference detected between unilateral and bilateral TKA patients.
This study investigated upon the different risk
factors that may be involved in delirium formation after total knee arthroplasty
in the geriatric population.
A retrospective analysis of 170 patients who had unilateral
or bilateral total knee arthroplasty was done. Knee
osteoarthritis, rheumatoid arthritis, spontaneous osteonecrosis of the knee,
and psoriatic arthritis was diagnosed at surgery. Gender, age, presence
of comorbidities, sedative usage, peri-operative loss of blood, pre- and
post-operative laboratory blood test outcomes were examined.
After the surgery, delirium was found in 11 patients
out of total 170 patients (6.5%) with a mean age of 79.5 (± 6.9) years. The
delirium group had higher age, sedative-hypnotics usage; low values of
pre-operative Hb and Ht, low values of post-operative Hb, Ht and BUN. According
to the multivariate logistic regression analysis, sedative usage and Hb level prior
to the operation were found to be independent risk factors for occurrence of
delirium after total knee arthroplasty (TKA). As per the receiver operating
characteristic curve analysis, Hb value of <11.1 g/dL before the surgery was
a predictor for the growth of delirium.
Delirium was found in elderly patients who
had pre-operative Hb level (< 11.1 g/dL) or who used sedative-hypnotics
after TKA. In such patients, the post-operative delirium risk can be reduced by
peri-operative management and undertaking preventative measures.
BMC Musculoskeletal disorders
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-020-03206-4#article-info
Pre-operative hemoglobin level and use of sedative-hypnotics are independent risk factors for post-operative delirium following total knee arthroplasty
Eiji Kijima et al.
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