Aging Clinical and Experimental Research

, Volume 29, Issue 2, pp 115–126 | Cite as

Risk factors for postoperative delirium following hip fracture repair in elderly patients: a systematic review and meta-analysis

  • Yanjiang Yang
  • Xin Zhao
  • Tianhua Dong
  • Zongyou Yang
  • Qi Zhang
  • Yingze ZhangEmail author



No formal systematic review or meta-analysis was performed up to now to summarize the risk factors of delirium after hip surgery.


The present study aimed to quantitatively and comprehensively conclude the risk factors of delirium after hip surgery in elderly patients.


A search was applied to CNKI, Embase, Medline, and Cochrane central database (all up to August 2015). All studies assessing the risk factors of delirium after hip surgery in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the Newcastle–Ottawa Scale. Data were pooled and a meta-analysis was completed.


A total of 24 studies were selected, which altogether included 5364 patients with hip fracture. One thousand and ninety of them were cases of delirium occurred after surgery, suggesting the accumulated incidence of 24.0 %. Results of meta-analyses showed that elderly patients with preoperative cognitive impairment [odds ratio (OR) 3.21, 95 % confidence interval (CI) 2.26–4.56), advanced age (standardized mean difference 0.50, 95 % CI 0.33–0.67), living in an institution (OR 2.94; 95 % CI 1.65–5.23), heart failure (OR 2.46; 95 % CI 1.72–3.53), total hip arthroplasty (OR 2.21; 95 % CI 1.16–4.22), multiple comorbidities (OR 1.37; 95 % CI 1.12–1.68) and morphine usage (OR 3.01; 95 % CI 1.30–6.94) were more likely to sustain delirium after hip surgery. Females were less likely to develop delirium after hip surgery (OR 0.83; 95 % CI 0.70–0.98).


Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent delirium after hip surgery.


Delirium Elderly patients Hip fracture Postoperative Risk factors 



We are grateful to C.W. and Y.Z. of the Department of Orthopedics, and to D.T. and Z.L. of the Department of Statistics and Applications for their kind assistance.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

40520_2016_541_MOESM1_ESM.doc (38 kb)
Supplementary material 1 (DOC 38 kb)


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Yanjiang Yang
    • 1
  • Xin Zhao
    • 3
  • Tianhua Dong
    • 1
  • Zongyou Yang
    • 1
  • Qi Zhang
    • 1
  • Yingze Zhang
    • 1
    • 2
    Email author
  1. 1.Department of Orthopaedic SurgeryThe Third Hospital of Hebei Medical UniversityShijiazhuangPeople’s Republic of China
  2. 2.Key Laboratory of Biomechanics of Hebei ProvinceShijiazhuangPeople’s Republic of China
  3. 3.Department of Functional and Physical ExaminationHebei General HospitalShijiazhuangPeople’s Republic of China

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