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Objective: To determine the risk factors of delirium in elderly patients after hip fracture surgery. Methods: We searched electronic bibliographic databases for eligible original studies published until November 2022. After literature screening, data extraction and quality evaluation, meta-analysis was performed using Stata17.0 and RevMan5.4. Results: A total of 16 studies were included, The incidence of delirium in elderly patients with hip fracture was 23.0% [95%CI= (20%~26%)]. The main risk factors for perioperative delirium in elderly patients with hip fracture were advanced age [OR=1.24, 95%CI = (1.10-1.40), P< 0.001], pain [OR=2.01, 95% CI = (1.48-2.75), P<0.001], stroke history [OR=5.22, 95%CI = (2.75-9.92), P<0.001], complications ≥3 [OR = 2.25,95%CI = (1.33-3.81), P=0.002], preoperative cognitive dysfunction [OR=3.45, 95%CI = (2.51-4.75), P<0.001], hypoxemia [OR=3.91, 95%CI = (2.70-5.67), P<0.001], long preoperative wait time [OR=3.98, 95%CI = (1.16-13.98), P=0.030], general anesthesia [OR=2.55, 95%CI = (1.81-3.59), P<0.001], long operation time [OR=1.61, 95%CI = (1.22-2.11), P<0.001], preoperative low albumin [OR=6.42, 95% CI= (2.59-15.88), P<0.001], low BMl [OR= 3.06, 95% CI= (1.71-5.46), P<0.001]. Conclusion: The incidence of postoperation delirium in elderly patients of hip fracture is high and there are many influencing factors. Early screening and intervention for delirium risk should be carried out to reduce the impact of adverse outcomes on patients. [ABSTRACT FROM AUTHOR]

Objective:To investigate the effect of dexmedetomidine (Dex) on postoperative recovery quality, quantitative electroencephalogram and delirium in elderly patients with osteoporosis complicated with femoral neck fracture. Methods: 97 elderly patients with osteoporosis complicated with femoral neck fracture who were treated in our hospital from January 2016 to March 2021 were selected, they were randomly divided into control group (48 cases) and Dex group (49 cases) by the random number table method. Total hip arthroplasty was performed in both groups, and Dex group was given 0.5 μg/kg Dex before anesthesia induction, and the control group was given the same amount of normal saline. The wake-up quality, hemodynamic changes and quantitative electroencephalogram frequency of the two groups were observed, and the occurrence of delirium and adverse anesthetic reactions were recorded. Results: Compared with the control group, the respiratory recovery time, extubation time and eye-opening time in Dex group were earlier (P<0.05). The heart rate (HR) at surgical excision of skin (T2)~finish the operation (T4) time point in both groups was lower than that at before anesthesia (T1) time point, and the mean arterial pressure (MAP) was higher than that at T1 time point, the intra-group comparison difference was statistically significant (P<0.05). HR at T2~T4 time point in Dex group was higher than that in control group, MAP was lower than that in control group at corresponding time points (P<0.05). δ wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation were increased compared with those before operation, and the Dex group was lower than the control group (P<0.05). The α1 wave frequencies of left frontal region, right frontal region, left temporal region and right temporal region in both groups at 1d after operation decreased compared with those before operation, and Dex group was higher than control group (P<0.05). The incidence of postoperative delirium in Dex group was lower than that in control group (P<0.05). There was no statistical difference in the incidence of adverse anesthetic reactions between the two groups (P>0.05). Conclusion: Dex is given to elderly patients with osteoporosis complicated with femoral neck fracture during operation, can improve the quality of postoper ative recovery without aggravating blood flow fluctuation, alleviate the influence on the δ, α1 wave frequency of the frontal lobe of the patient, and it can reduce the incidence of delirium. [ABSTRACT FROM AUTHOR]