$Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study$
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Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study

Background This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orth...

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Published in:	Aging clinical and experimental research Vol. 35; no. 11; pp. 2499 - 2506
Main Authors:	Gandossi, Chiara Maria, Zambon, Antonella, Ferrara, Maria Cristina, Tassistro, Elena, Castoldi, Giuseppe, Colombo, Francesca, Mussi, Chiara, Martini, Emilio, Sergi, Giuseppe, Coin, Alessandra, Zatti, Giovanni, Trevisan, Caterina, Volpato, Stefano, Ungar, Andrea, Bellelli, Giuseppe
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-11-2023 Springer Nature B.V
Subjects:	Delirium Fractures Frailty Geriatrics/Gerontology Hip joint Medicine Medicine & Public Health Original Original Article Delirium Frailty Hip fracture Orthogeriatric Functional outcome
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Abstract	Background This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. Results 984 patients (median age 84 years, IQR = 79–89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19–2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02–3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85–7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21–4.66, p < 0.001). Conclusions POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.
AbstractList	This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. 984 patients (median age 84 years, IQR = 79-89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19-2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02-3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85-7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21-4.66, p < 0.001). POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients. BACKGROUNDThis study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF).METHODSMulticenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes.RESULTS984 patients (median age 84 years, IQR = 79-89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19-2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02-3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85-7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21-4.66, p < 0.001).CONCLUSIONSPOD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients. Background This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. Results 984 patients (median age 84 years, IQR = 79–89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19–2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02–3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85–7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21–4.66, p < 0.001). Conclusions POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.
Author	Ungar, Andrea Bellelli, Giuseppe Volpato, Stefano Tassistro, Elena Ferrara, Maria Cristina Martini, Emilio Sergi, Giuseppe Castoldi, Giuseppe Coin, Alessandra Gandossi, Chiara Maria Trevisan, Caterina Colombo, Francesca Zatti, Giovanni Zambon, Antonella Mussi, Chiara
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Copyright	The Author(s) 2023 2023. The Author(s). The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Keywords	Delirium Frailty Hip fracture Orthogeriatric Functional outcome
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Snippet	Background This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up... This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients... BackgroundThis study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up... BACKGROUNDThis study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up...
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StartPage	2499
SubjectTerms	Delirium Fractures Frailty Geriatrics/Gerontology Hip joint Medicine Medicine & Public Health Original Original Article
Title	Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study
URI	https://link.springer.com/article/10.1007/s40520-023-02522-8 https://www.ncbi.nlm.nih.gov/pubmed/37542601 https://www.proquest.com/docview/2886465976 https://search.proquest.com/docview/2846927993 https://pubmed.ncbi.nlm.nih.gov/PMC10628048
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