Postoperative delirium mediates 180-day mortality in orthopaedic trauma patients

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dc.contributor.authorPedemonte, Juan C.
dc.contributor.authorSun, Haoqi
dc.contributor.authorFranco-Garcia, Esteban
dc.contributor.authorZhou, Carmen
dc.contributor.authorHeng, Marilyn
dc.contributor.authorQuraishi, Sadeq A.
dc.contributor.authorWestover, Brandon
dc.contributor.authorAkeju, Oluwaseun
dc.date.accessioned2025-01-20T22:13:21Z
dc.date.available2025-01-20T22:13:21Z
dc.date.issued2021
dc.description.abstractBackground: Frailty has been associated with increased incidence of postoperative delirium and mortality. We hypothesised that postoperative delirium mediates a clinically significant (>= 1%) percentage of the effect of frailty on mortality in older orthopaedic trauma patients.
dc.description.abstractMethods: This was a single-centre, retrospective observational study including 558 adults 65 yr and older, who presented with an extremity fracture requiring hospitalisation without initial ICU admission. We used causal statistical inference methods to estimate the relationships between frailty, postoperative delirium, and mortality.
dc.description.abstractResults: In the cohort, 180-day mortality rate was 6.5% (36/558). Frail and prefrail patients comprised 23% and 39%, respectively, of the study cohort. Frailty was associated with increased 180 day mortality from 1.4% to 12.2% (11% difference; 95% confidence interval [CI], 8.4-13.6), which translated statistically into an 88.7% (79.9-94.3%) direct effect and an 11.3% (5.7-20.1%) postoperative delirium mediated effect. Prefrailty was also associated with increased 180 day mortality from 1.4% to 4.4% (2.9% difference; 2.4-3.4), which was translated into a 92.5% (83.8-99.9%) direct effect and a 7.5% (0.1-16.2%) postoperative delirium mediated effect.
dc.description.abstractConclusions: Frailty is associated with increased postoperative mortality, and delirium might mediate a clinically significant, but small percentage of this effect. Studies should assess whether, in patients with frailty, attempts to mitigate delirium might decrease postoperative mortality.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.bja.2021.03.033
dc.identifier.eissn1471-6771
dc.identifier.issn0007-0912
dc.identifier.urihttps://doi.org/10.1016/j.bja.2021.03.033
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94447
dc.identifier.wosidWOS:000675498200026
dc.issue.numero1
dc.language.isoen
dc.pagina.final109
dc.pagina.inicio102
dc.revistaBritish journal of anaesthesia
dc.rightsacceso restringido
dc.subjectfrailty
dc.subjectmortality
dc.subjectorthopaedic trauma
dc.subjectperioperative
dc.subjectpostoperative delirium
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePostoperative delirium mediates 180-day mortality in orthopaedic trauma patients
dc.typeartículo
dc.volumen127
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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