Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Nov;35(11):2499-2506.
doi: 10.1007/s40520-023-02522-8. Epub 2023 Aug 5.

Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study

Chiara Maria Gandossi  1 , Antonella Zambon  2   3 , Maria Cristina Ferrara  4 , Elena Tassistro  5 , Giuseppe Castoldi  6 , Francesca Colombo  6 , Chiara Mussi  7 , Emilio Martini  7 , Giuseppe Sergi  8 , Alessandra Coin  8 , Giovanni Zatti  1   9 , Caterina Trevisan  10   11 , Stefano Volpato  10   11 , Andrea Ungar  12 , Giuseppe Bellelli  13   14 ; GIOG 2.0 Study Group, Società Italiana di Gerontologia e Geriatria (SIGG)
Collaborators, Affiliations
Observational Study

Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study

Chiara Maria Gandossi et al. Aging Clin Exp Res. 2023 Nov.

Abstract

Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF).

Methods: Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes.

Results: 984 patients (median age 84 years, IQR = 79-89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19-2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02-3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85-7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21-4.66, p < 0.001).

Conclusions: POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.

Keywords: Delirium; Frailty; Functional outcome; Hip fracture; Orthogeriatric.

PubMed Disclaimer

Conflict of interest statement

All Authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of the patients’ selection process
See this image and copyright information in PMC

References

    1. Agenas - Agenzia Nazionale per i servizi sanitari Regionali AGENAS. http://pne2017.agenas.it/. Accessed 18 Jan 2023
    1. Maggi S, Siviero P, Wetle T, Besdine RW, Saugo M, Crepaldi G. A multicenter survey on profile of care for hip fracture: predictors of mortality and disability. Osteoporos Int. 2010;21:223–231. doi: 10.1007/s00198-009-0936-8. - DOI - PubMed
    1. Bellelli G, Mazzola P, Corsi M, et al. The combined effect of ADL impairment and delay in time from fracture to surgery on 12-month mortality: an observational study in orthogeriatric patients. J Am Med Dir Assoc. 2012;13:e9–664.e14. doi: 10.1016/j.jamda.2012.06.007. - DOI - PubMed
    1. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C, IOF Working Group on Epidemiology and Quality of Life A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23:2239–2256. doi: 10.1007/s00198-012-1964-3. - DOI - PMC - PubMed
    1. Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int. 1997;7:407–413. doi: 10.1007/pl00004148. - DOI - PubMed

Publication types