Predictors of post-operative delirium (POD) in geriatric patients undergoing hip surgeryHelen Miley, Kathleen Russell Babin, Sharon Lubeck , and Amy Wozniak
Post operative delirium (POD) in the geriatric patient with hip surgery is a major complication that leads to increased stress to the patient, family, health care providers and the community. Literature estimated that delirium in the elderly post op hip patient is as high as 52.2% 1. Patients who develop POD have longer length of stays, increased incidence of dementia, and have more hospital-acquired complications, such as falls and pressure sores. They are also more likely to be admitted to long-term care, and more likely to die2. At a hospital in Ocean County, New Jersey, approximately 5-10 hip surgeries per week are performed, and the staff nurses were seeking a proactive method to predict the incidence of POD so the care plan for delirium can be instituted early in the course of the hospital stay.
After a thorough review of the evidence, little consensus was seen for predictors of delirium in this specific population. In fact, over 50 predictors of POD were identified by different authors. Therefore, a retrospective chart review was conducted of randomly selected patients over the age of 65 years from 2010 who underwent hip surgery. This research identified three factors that correlated with POD: Benzodiazepine use on day one post-op, low hematocrit on day one and history of depression. A pilot is now in place to retest these predictors and also to examine if delirium incidence changes through early intervention.