HYPOXIA AND POSTOPERATIVE DELIRIUM IN ELDERLY PATIENTS SUFFERING FROM A HIP FRACTURE AND THE CORRELATION BETWEEN THEM.

Abstract

Purpose: It is known that postoperative delirium and hypoxia are factors that make mobilisation of elderly patients more difficult. Our purpose was to estimate the rate of hypoxia and delirium postoperatively, and their possible correlation, in elderly people suffering from a hip fracture.

Material: One hundred-seventeen patients (35 male, 82 female) over 65 years old were studied. Sixty two of them, who had a fracture of the neck of the femur and 15 with an intertrochanteric fracture were treated with a hemiarthroplasty, and 40 who sustained an intertrochanteric fracture were treated with internal fixation with a gliding screw and a plate. Spinal anaesthesia was used in all patients. Their age was 65–97 (average 79, 7). Patients suffering from dementia or Alzheimer were excluded.

Method: We counted satO2 preoperatively and until the fourth postoperative day. Postoperative delirium was assessed with the Confusion Assessment Method (CAM). Postoperatively, O2 was given at patients with satO2< 90 or when saturation was 5% lower than the preoperative.

Results: Hypoxia occurred in 60 patients (51,28%), which was usually reduced until the 4th pop day. In two patients who suffered from chronic respiratory failure, hypoxia persisted until the 10th pop day.

Postoperative delirium occurred in 31 patients (26,5%). Seventeen of then had also hypoxia. Two patients didn’t recover until their discharge from the hospital. In one of them the delirium persists 3 months pop. Correlation between delirium and hypoxia was not noticed (p< 0,0024), neither the delirium was better after the administration of O2 in hypoxaemic patients, altought satO2 was made better.

Conclusion: Hypoxia, postoperatively, in elderly patients, sufering from hip fracture is usual, but it is made better after the 4th pop day. Postoperative delirium in these patients is also usual. In our study there was no correlation between delirium and hypoxia. Delirium wasn’t any better after administration of O2.