Several studies have shown that frailty can be used as a marker for risk of adverse outcomes in elderly patients such as falls, disability, hospitalization, mortality, and can be used to predict patient clinical outcomes. The purpose of this study is to determine whether preoperative frailty can be used as a diagnostic and predictive factor for postoperative delirium in elderly patients with hip fracture.
Frailty index (FI) is a reliable method to determine the assessment of frailty in elderly patients. Multiple prospective cohort studies have shown that frailty can be used as a marker for risk of adverse outcomes in older adults such as falls, disability, hospitalization, and mortality, and can be used to predict patient clinical outcomes. Whether frailty could be used as a diagnostic and predictive factor for delirium is urgently needed in a large population. Therefore, this project intends to conduct a prospective cohort study. Patients will be divided into three groups according to frailty index (FI) before surgery, and delirium status will be evaluated by using scales after surgery, so as to explore the diagnostic and predictive value of frailty on POD. Once confirmed, the results of this study will be helpful for the early identification, screening, diagnosis and evaluation of treatment effect of POD. It is of great scientific significance and social benefit to reduce the incidence of POD, improve the prognosis of vulnerable patients and reduce the burden of disease.
Study Type
OBSERVATIONAL
Enrollment
300
There are clinically common scales for assessing weakness and delirium.
Beijing Tsinghua Changgung Hospital
Beijing, Beijing Municipality, China
RECRUITINGIncidence of postoperative delirium（POD） in elderly patients with hip fracture
The percentage of the study population who developed delirium within seven days of surgery,postoperative delirium（POD） is defined according to the CAM criterion
Time frame: Postoperative 7 days
Duration of delirium
The time between the first appearance of delirium
Time frame: Postoperative 7 days
Delirium drug use
dosage and name of medication prescribed by a neurologist
Time frame: Postoperative 7 days
Length of hospital stay (HLOS)
Collection of clinical data in the medical record
Time frame: Postoperative 30 days
Length of ICU stay
Collection of clinical data in the medical record
Time frame: Postoperative 30 days
Hospital cost
Expenses during hospitalization
Time frame: Postoperative 30 days
Dindo-Clavien Classification{References:Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240(2):205-213.}
Incidence of serious adverse reactions within 30 days after operation （the therapy used to correct a specific complication is the basis of this classification in order to rank a complication in an objective and reproducible manner. It consists of 7 grades (I, II, IIIa, IIIb, IVa, IVb and V). The introduction of the subclasses a and b allows a contraction of the classification into 5 grades (I, II, III, IV and V) depending on the size of the population observed or the of the focus of a study. Complications that have the potential for long-lasting disability after patient's discharge are highlighted in the present classification by a suffix ("d" for disability). This suffix indicates that a follow-up is required to comprehensively evaluate the outcome and related long-term quality of life.）
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Time frame: Postoperative 30 days
Death before and 30 days after discharge
Collection of clinical data in the medical record and follow-up update through telephone
Time frame: 30 days after discharge