REVIEW article
Front. Med.
Sec. Geriatric Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1617891
This article is part of the Research TopicPost-Operative Neuropsychiatric Disorders, volume IIView all 6 articles
Perioperative blood loss is a risk factor for postoperative delirium in geriatric hip fracture patients: A retrospective study
Provisionally accepted
- The Second People’s Hospital of China Three Gorges University, Yi chang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Postoperative delirium (POD) is a common and serious complication in elderly patients with hip fractures and is associated with adverse outcomes. The aim of this study was to investigate perioperative blood loss as a potential risk factor for POD.This retrospective cohort study included electronic medical records of hip fracture patients admitted to Yichang Second People's Hospital from January 2020 to June 2024, with a total of 247 patients. POD was diagnosed using the Confusion Assessment Method (CAM) on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Perioperative blood loss was calculated using the Gross linear equation for red blood cell volume, and preoperative blood volume (PBV) was estimated using the Nadler formula. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for POD.The incidence of POD was 39.7% (98/247). Multivariate analysis revealed that increased intraoperative blood loss (OR: 6.017, 95% CI: 3.325-10.887, p < 0.001), prolonged surgical duration (OR:1.072, 95% CI: 1.045-1.101, p < 0.001), history of coronary heart disease (OR: 3.175, 95% CI: 1.546-6.519, p = 0.002), and history of cerebral infarction (OR: 3.170, 95% CI: 1.546-6.497, p = 0.002) were independent risk factors for POD. Binary logistic regression revealed a significant dose-response relationship between blood loss and POD susceptibility (all p<0.05). No significant associations were found with age, sex, or BMI.This study confirms that perioperative blood loss is an independent and modifiable risk factor for POD in elderly hip fracture patients. On the basis of these findings, optimizing perioperative management-such as reducing intraoperative blood loss and shortening surgical duration-may serve as an effective strategy to lower the incidence of POD in this population.
Keywords: postoperative delirium, Hip fracture, Geriatrics, Blood loss, Risk factors
Received: 25 Apr 2025; Accepted: 11 Jul 2025.
Copyright: © 2025 Deng, Zhang, Xie and Zeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jingshan Zeng, The Second People’s Hospital of China Three Gorges University, Yi chang, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.