Preoperative Distress and Postoperative Delirium in Elderly Patients Undergoing Major Orthopedic Surgery

Elazıg Fethi Sekin Sehir Hastanesi150 enrolled

Overview

Postoperative delirium is a common and serious complication in elderly patients undergoing major orthopedic surgery and is associated with increased morbidity, prolonged hospital stay, and higher healthcare costs. Preoperative psychological distress has been suggested as a potential risk factor influencing postoperative outcomes; however, its relationship with delirium and other clinical outcomes remains insufficiently explored. This prospective observational study aims to investigate the association between preoperative distress levels and postoperative delirium, pain intensity, and length of hospital stay in elderly patients undergoing major orthopedic surgery. Preoperative distress will be assessed using validated tools, and postoperative outcomes including delirium incidence, pain scores, and hospital stay duration will be recorded and analyzed. The findings of this study are expected to contribute to improved perioperative risk stratification and may support the development of targeted interventions to reduce postoperative complications in this vulnerable patient population.

Study Type

OBSERVATIONAL

Enrollment

150

Conditions

Postoperative Delirium

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria * Age ≥65 years * Undergoing major orthopedic surgery, including: * Hip fracture surgery * Primary or revision hip arthroplasty * Primary knee arthroplasty * Ability to provide informed consent or availability of a legally authorized representative Exclusion Criteria * Known diagnosis of severe dementia or significant cognitive impairment * Presence of preoperative delirium or an active diagnosis of delirium * Severe hearing or visual impairment preventing effective communication * History of intracranial surgery or neurological diseases significantly increasing the risk of delirium (e.g., advanced Parkinson's disease, severe stroke sequelae) * Planned postoperative sedation in the intensive care unit

Outcomes

Primary Outcomes

Incidence of Postoperative Delirium

The primary outcome of the study is the incidence of postoperative delirium in elderly patients undergoing major orthopedic surgery. Delirium will be assessed during the postoperative period using a validated delirium assessment method.

Time frame: Within the first 3 postoperative days

Secondary Outcomes

Postoperative Pain Intensity

Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS), a validated 11-point scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores represent greater pain intensity. Pain scores will be recorded at predefined time points (e.g., 2, 6, 12, and 24 hours postoperatively) under resting conditions by trained healthcare personnel. In addition, the association between postoperative pain intensity and preoperative distress levels will be analyzed.

Time frame: Within the first 24 postoperative hours