[Use of procholinergics in the prevention of postoperative delirium in hip fracture surgery in the elderly. A randomized controlled trial].
BACKGROUND
40 to 50% of elderly with hip fracture present delirium. The morbimortality increase in patients whose presented delirium.


OBJECTIVE
To study the use of citicoline (CDP choline) in the prevention of delirium in elderly under hip fracture surgery.


METHODS
A randomized control trial. The patients with hip fracture without dementia or an other organic brain illness. The medication were administered 24 hours before and during 4 days after surgery. The doses was 1.2 g/day. The primary outcome measure was percentage of patients with delirium measured with Abbreviated Mental Test (AMT) and Confusion Assessment Method (CAM). The Mini Mental State (MMS) was used before and 4 days after surgery. All treatment comparation was considered statistically significant at p< 0.05 calculating chi square and Wilcoxon test.


RESULTS
The sample size was 81 patients (46 placebo and 35 citicoline). The mean age was 79.45 for tested group and 79.97 for placebo. There was no statistically significant difference between groups with respect to ASA class of anesthesia. The incidence of delirium was 17.39% in placebo and 11.76% in citicoline group (p= 0.6). CAM and AMT at 1, 2, 3, 4 days post surgery was not significant in placebo and citicoline group (p= 0.8 and p= 0.34).


CONCLUSIONS
In the present study the citicoline did not prevent or reduce the incidence of delirium in hip fracture surgery in elderly.
Díaz
V
V
Dpto. de Neurología; Hospital Clínico de la Universidad de Chile Dr. Jose Joaquín Aguirre, Santiago de Chile, Chile. vdiaz@machi.med.uchile.cl
Rodríguez
J
J
Barrientos
P
P
Serra
M
M
Salinas
H
H
Toledo
C
C
Kunze
S
S
Varas
V
V
Santelices
E
E
Cabrera
C
C
Farías
J
J
Gallardo
J
J
Beddings
M I
MI
Leiva
A
A
Cumsille
M A
MA
D000368:Aged; D000369:Aged, 80 and over; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D003693:Delirium / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D018697:Nootropic Agents / Q000627:therapeutic use; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control*
D018697:Nootropic Agents; D010919:Placebos; D003566:Cytidine Diphosphate Choline
Utilización de procolinérgicos en la prevención del delirio post operatorio del adulto mayor sometidos a cirugía de fractura de cadera. Ensayo clínico controlado.