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Postoperative delirium in patients who have hip fractures may lead to poor outcomes. This study aimed to determine perioperative risk factors and clinical outcomes of postoperative delirium in patients undergoing hip bipolar hemiarthroplasty for displaced femoral neck fractures.Among 1,353 patients who underwent hemiarthroplasty at our institution during 2013-2021, we identified 78 patients with postoperative delirium diagnosed with the confusion assessment method. The mean delirium duration was 28 hours (range: 15-520). We also included 1:2 sex- and age-matched patients who did not have postoperative delirium after the same surgery as a matching cohort for comparison. Patient comorbidities, perioperative data, delirium occurrence, and outcomes were collected for analyses.A Charlson Comorbidity Index (CCI) score ≥6 (odds ratio (OR): 2.08, P = .017), nighttime surgery (OR: 3.47, p =.001), surgical delays (OR: 1.01, P = .012), preoperative anemia (OR: 2.1, P = .012), and blood transfusions (OR: 2.47, P = .01) may increase the risk of postoperative delirium. The presentation of delirium was associated with sepsis (OR: 3.77, P = .04), longer hospital stays (P.001), higher 1-year mortality (OR: 3.97, P = .002), and overall mortality (OR: 2.1, P = .02).Postoperative delirium predicted poor outcomes. Our results emphasized the importance of early identification of patients at risk and optimization of the medical conditions before and after surgery.

Drainage-clamping methods are thought to be effective in reducing blood loss after total knee arthroplasty (TKA). We conducted a systematic review to examine if these methods were effective without increasing the risk of complications. After a comprehensive search, 6 randomized controlled trials involving 603 knees and comparing clamping drainage and the immediate release of the drain after elective TKA were included in this analysis. The results demonstrated that drainage clamping could decrease the volume of drainage, but only clamping for no less than 4 hours could reduce the true blood loss. There was no significant difference between the 2 groups regarding blood transfusion, postoperative range of motion, incidence of thromboembolic events, and wound complications. The current evidence cannot confirm the advantage of clamping drainage after TKA.

Drainage-clamping methods are thought to be effective in reducing blood loss after total knee arthroplasty (TKA). We conducted a systematic review to examine if these methods were effective without increasing the risk of complications. After a comprehensive search, 6 randomized controlled trials involving 603 knees and comparing clamping drainage and the immediate release of the drain after elective TKA were included in this analysis. The results demonstrated that drainage clamping could decrease the volume of drainage, but only clamping for no less than 4 hours could reduce the true blood loss. There was no significant difference between the 2 groups regarding blood transfusion, postoperative range of motion, incidence of thromboembolic events, and wound complications. The current evidence cannot confirm the advantage of clamping drainage after TKA.