• Wenliang Chen, Xiurong Ke, Xiaoqing Wang, Xiaoliang Sun, Juncheng Wang, Guojing Yang, Haijie Xia, and Lei Zhang.
• Department of adult reconstruction, the third affiliated hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325200, China.
• Gen Hosp Psychiatry. 2017 May 1; 46: 55-61.

BackgroundThe aim of this prospective study was to investigate the incidence and clinical features of delirium after total joint arthroplasty, and to establish the potential risk factors for postoperative delirium.MethodsA total of 212 consecutive patients undergoing hip or knee arthroplasty, who met the inclusion and exclusive criteria were enrolled. The general characteristics, preoperative and postoperative hematological variables were documented respectively. According to the presence of delirium, all patients were divided into the delirium group and non-delirium group. Univariate and multivariate logistic regression were performed to identify the possible predictors for postoperative delirium.ResultsAt a minimum of 6months of follow-up, 35 patients were observed with postoperative delirium at an estimated total incidence of 16.5%. The incidence of delirium was statistically higher in hip arthroplasty (22.8%) than that in knee arthroplasty (7.1%). The multivariate regression analysis identified older age (OR=1.590, P=0.023), a history of stroke (OR=190.23, P=0.036), preoperative PaO2 (OR=1.277, P=0.018) and equivalent fentanyl dose (OR=1.010, P=0.012) as the predictive factors for postoperative delirium after total joint arthroplasty.ConclusionsThe incidence of postoperative delirium after total joint arthroplasty is higher than expected. Based on our findings, we suggest that the surgeons should focus on those patients who have these risk factors and ensure the appropriate management to avoid postoperative delirium.Copyright © 2017 Elsevier Inc. All rights reserved.

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