Delirium is a common complication following hip fracture surgery (HFS) in older people. Postoperative hypoxia has also been associated with delirium, but not specifically in geriatric patients. The aim of the study is to demonstrate that post-operative hypoxia is associated with in-hospital complications in patients with HFS.
Patients hospitalized in orthogeriatric unit after HFS will be monitored for nocturnal SpO2 with a pulse oximeter continuously during 3 nights. In-hospital complications will be recorded prospectively in all patients, especially the occurrence of delirium with the CAM scale. The hypoxia vs non-hypoxia (more than 20% of the time spent with SpO2\<90%) groups will be analyzed for clinical characteristics, comorbidities and medication use. The statistical association between severe post-operative nocturnal hypoxemia and occurrence of delirium will be assessed. The dependance between this association and daytime SpO2 will also be assessed. The potential confirmation of an association between post-operative nocturnal hypoxemia in patients with HFS and the occurrence of delirium will lead the reflection on a clinical trial testing the benefit of oxygen therapy in the prevention of post-operative delirium, to improve the medical care of orthogeriatric patients.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
70
Nocturnal oxymetry data will be continuously collected during nighttime by a pulse oxymeter, covering for 1 to 3 nights.
Service de gériatrie, Hopital Saint Antoine
Paris, France
RECRUITINGService de Gériatrie Hopital de La Pitié Salpetriere
Paris, France
RECRUITINGDelirium
Delirum or not, diagnosed with CAM (Confusion Assessment Method). Association between nocturnal hypoxia and delirium will be study.
Time frame: Month 1
In-hospital complications
Occurrence of in-hospital complications (infection, cardiac, etc). Association between nocturnal hypoxia and others medical complications (infection, cardiac, etc) will be study.
Time frame: Month 1
Length of hospitalisation stay in othogeriatrics unit
Length of stay in othogeriatrics unit. Association between nocturnal hypoxia and length of hospitalisation stay in othogeriatrics unit will be study.
Time frame: Month 1
walking status (functional status)
walking status (possible with/without help, wheelchair or bedridden) Association between nocturnal hypoxia and functional status will be study.
Time frame: Month 1
walking status (functional status)
walking status (possible with/without help, wheelchair or bedridden). Association between nocturnal hypoxia and functional status will be study.
Time frame: Month 1
walking speed (functional status)
walking speed for 5 meter. Association between nocturnal hypoxia and functional status will be study.
Time frame: Month 1
Physical performance (functional status)
Short Physical Performance Battery (SPPB) is an objective assessment tool for evaluating lower extremity functioning in older persons.
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Time frame: Month 1
Dependency
Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) are instrument to assess independent living skills. Association between nocturnal hypoxia and independent living skills will be study.
Time frame: Month 1
Dependency
Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) are instrument to assess independent living skills. Association between nocturnal hypoxia and independent living skills will be study.
Time frame: Month 6
Mortality
Vital status will be raised
Time frame: Month 1
Mortality
Vital status will be raised
Time frame: Month 6
Nocturnal hypercapnia
Nocturnal hypercapnia defined by more than 10% time spent with a transcutaneous TcPCO2 ≥50mmHg
Time frame: Month 1