Incidence and associated factors of postoperative delirium among elderly elective orthopedic surgical patients in selected Addis Ababa Public hospitals
| dc.contributor.advisor | Abiy,Sileshi(BSc, MSc) | |
| dc.contributor.advisor | Seifu,Ashenafi(BSc, MSc) | |
| dc.contributor.author | Asrat,Yegle | |
| dc.date.accessioned | 2025-08-12T20:11:42Z | |
| dc.date.available | 2025-08-12T20:11:42Z | |
| dc.date.issued | 2024-05 | |
| dc.description.abstract | Background: Delirium is a neurocognitive disorder characterized by an acute and relatively rapid decline in cognition, disturbance of consciousness, reduced ability to focus and shift of attention. Additionally, it is well recognized that it mostly affects elderly patients, and its incidence is increased during the postoperative period. Occurring in 8% to 20% of older patients after an operation, and frequently it occurs between 24 hours and 5 days after surgery. And it can result in serious medical management problem; therefore, identification of the possible contributing factors and magnitude of the burden will help in the management of delirium in elderly patients. Objective: To assess the incidence and associated factors of postoperative delirium among elderly elective orthopedic surgical patients in selected Addis Ababa public hospitals, Ethiopia, from February 2024 to May 2024. Method and tools: A multi-center longitudinal study was conducted on elderly patients in four selected Addis Ababa public hospitals from February 2024 to May 2024, and a systematic sampling technique was used to select the study participants. Patients aged ≥65 years old who underwent elective orthopedic surgery were included in this study. Data was collected through chart review and interview of patients, and postoperative delirium was assessed by using confusion assessment method (CAM). Both bivariable and multivariable logistic regression model were used for statistical analysis. Results: 220 patients who underwent elective orthopedic surgery at four selected Addis Ababa public hospitals were included; most of the patients were male, 68.1% of the patients underwent lower extremity surgery, and 62.3% of the patients received spinal anesthesia. The incidence of postoperative delirium among elderly elective orthopedic surgical patients was 33.7%, and age 65-75(AOR =0.468, 95%CI (0.226-0.97),perioperative opioid usage (AOR=2.200, 95%CI (1.073-4.5313), intraoperative anticholinergic usage(AOR=2.238,95%CI(1.831-4.235),history of hospitalization(AOR=2.24,95%CI(1.202-4.206),and blood transfusion (AOR=2.83,95%CI(1.295 -6.193) were significantly associated with postoperative delirium. Conclusion: The incidence of postoperative delirium among elderly elective orthopedic surgical patients was high in the study area (33.7%); advanced age, blood transfusion, intraoperative anticholinergic usage, pervious history of hospitalization and perioperative opioid usage were the associated factors for postoperative delirium. Recommendation: We recommend that special attention should be paid for elderly patients with history of hospitalization, blood transfusion, who use opioid and anticholinergic medications. in addition to this, reducing opioid-based pain treatment is important. We also recommend that feature researchers to do ongoing research on long-term impact of postoperative delirium on elderly patients. | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/6525 | |
| dc.language.iso | en_US | |
| dc.publisher | Addis Ababa University | |
| dc.subject | Orthopedic surgery | |
| dc.subject | Postoperative delirium | |
| dc.subject | Confusion assessment method. | |
| dc.title | Incidence and associated factors of postoperative delirium among elderly elective orthopedic surgical patients in selected Addis Ababa Public hospitals | |
| dc.type | Thesis |