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Delirium is a serious psychiatric disorder, and elderly patients who undergo hip surgery are at higher risk for delirium development.The purpose was to compare change in cognitive function and health-related quality of life 6 months after hip surgery in patients who experienced postoperative delirium with those who did not.A total of 115 patients 75 years or older were included.Screening for delirium was done using the Diagnostic and Statistical Manual, 4th ed criteria. Cognitive function was measured with the Mini Mental State Examination and health-related quality of life with the SF-36.Of the 115 patients, 32 became delirious during hospital stay (D group), whereas the remaining patients did not (NonD group). Both D and NonD groups scored lower on the Mini Mental State Examination at follow-up than during hospital stay, but the deterioration was significantly greater in the D group. At follow-up, health-related quality of life was improved in patients who were destined for hip replacement surgery but unchanged or impaired for those with hip fracture. Delirium onset in connection with hip fracture lowered the health-related quality of life even more. At follow-up, low cognitive function correlated with lower scoring in physical function. Greater knowledge about delirious patients' vulnerable positions related to lower cognition and life quality can improve rehabilitation and support for these patients.