Association of Frailty and Delirium in Elderly Hip Fracture Patients

The Association of Preoperative Frailty Index and Incidence of Postoperative Delirium in Elderly Patients With Hip Fracture: a Prospective Cohort Study

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.

Inclusion Criteria:

• The subjects were patients with hip fracture;
• Older than 65 years;
• Patients signed informed consent;
• American Society of Anesthesiologist (ASA) Rated I- III;
• The surgery was performed by the same anesthesia and surgical team.

Exclusion Criteria:

• Patients cannot sign the consent form or refuse to participate;
• A history of cognitive impairment;
• Unable to complete the cognitive function test;
• Mental disorder during initial assessment;
• Patients suffering from mental illness or substance use disorder;
• Incomplete or lost data during follow-up.