title: General versus spinal anaesthesia and postoperative delirium in an orthogeriatric population.
abstract: OBJECTIVE
  Postoperative delirium is common among elderly hip surgery patients. We aimed to pragmatically evaluate whether type of anaesthesia influenced postoperative delirium in an orthogeriatric population following hip fracture.
  
  
  METHODS
  This observational study comprises prospectively collected data on hip fracture patients admitted between October 2010 and November 2011. Delirium was diagnosed clinically by geriatricians.
  
  
  RESULTS
  Of the 344 patients admitted, seven managed conservatively and 19 with incomplete data were excluded; 318 patients were analysed. Average age was 81.6 (SD 9.8) years; 28% were men and 167 (53%) were administered general anaesthesia. Mean length of stay was 18 (SD 9.4) days. Overall, 172 patients (54%) experienced delirium. There was no apparent difference in postoperative delirium by anaesthetic type (88 vs 84, P = 0.15).
  
  
  CONCLUSIONS
  Delirium was common in both general and spinal anaesthetic patients. Further randomised controlled trials would be required to determine whether anaesthesia type influenced delirium rates.
authors.affiliation: Internal Medical Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Sivarajah
authors.initials: S
authors.lastname: Ilango
authors.affiliation: Internal Medicine and Geriatric Medicine Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Ranjeev Chrys
authors.initials: RC
authors.lastname: Pulle
authors.affiliation: Nutrition and Dietetics, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Jack
authors.initials: J
authors.lastname: Bell
authors.affiliation: Allied Health, The Prince Charles Hospital, Brisbane, Queensland, Australia.|Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Kuys
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D003693:Delirium / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005260:Female; D005592:Fracture Fixation; D006620:Hip Fractures / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: anaesthesia; delirium; hip fractures; hip surgery; older people; postoperative complications