uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Cognitive function and health-related quality of life after delirium in connection with hip surgery: a six-month follow-up
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
2004 (English)In: Orthopedic Nursing, ISSN 0744-6020, E-ISSN 1542-538X, Vol. 23, no 3, 195-203 p.Article in journal (Refereed) Published
Abstract [en]

NEED: Delirium is a serious psychiatric disorder, and elderly patients who undergo hip surgery are at higher risk for delirium development.


The purpose was to compare change in cognitive function and health-related quality of life 6 months after hip surgery in patients who experienced postoperative delirium with those who did not.


A total of 115 patients 75 years or older were included.


Screening for delirium was done using the Diagnostic and Statistical Manual, 4th ed criteria. Cognitive function was measured with the Mini Mental State Examination and health-related quality of life with the SF-36.


Of the 115 patients, 32 became delirious during hospital stay (D group), whereas the remaining patients did not (NonD group). Both D and NonD groups scored lower on the Mini Mental State Examination at follow-up than during hospital stay, but the deterioration was significantly greater in the D group. At follow-up, health-related quality of life was improved in patients who were destined for hip replacement surgery but unchanged or impaired for those with hip fracture. Delirium onset in connection with hip fracture lowered the health-related quality of life even more. At follow-up, low cognitive function correlated with lower scoring in physical function. Greater knowledge about delirious patients' vulnerable positions related to lower cognition and life quality can improve rehabilitation and support for these patients.

Place, publisher, year, edition, pages
2004. Vol. 23, no 3, 195-203 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-91142PubMedID: 15211901OAI: oai:DiVA.org:uu-91142DiVA: diva2:163760
Available from: 2003-11-18 Created: 2003-11-18 Last updated: 2013-05-16Bibliographically approved
In thesis
1. Delirium during Hospitalisation: Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious
Open this publication in new window or tab >>Delirium during Hospitalisation: Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Delirium is common among old patients admitted to hospital, but is often a neglected problem in patient care. The principal aim of this thesis was to evaluate aspects of delirium in relation to incidence, risk factors, behavioural changes, cognitive function and health-related quality of life (HRQOL). A further aim was to describe patients’ experiences of being delirious. The study was prospective, descriptive and comparative, with repeated measures (six-month follow up). The sample consisted of 225 consecutive patients, aged 65 years or older, who were to be operated on due to hip fracture or hip replacement. Exclusion criteria were serious cognitive disorder or delirium on admission. Data were collected via frequent daily observations, cognitive functioning tests (MMSE), HRQOL questionnaires (SF-36) and interviews. Delirium was assessed according to the DSM-IV criteria. A total of 45/225 became delirious, with an incidence of 24.3% among patients undergoing hip fracture surgery and 11.7% among those with hip replacement surgery. A predictive model for delirium included four factors: impaired hearing, passivity, low cognitive functioning, and waiting more than 18h for hip fracture surgery. Disorientation and urgent calls for attention were the most frequent behavioural changes in the prodromal phase prior to delirium. Delirium in connection with hip fracture revealed deteriorated HRQOL and cognitive functioning when measured at a six-month follow-up. The experience of being delirious was described by the patients as a sudden change of reality. Such an experience gave rise to strong emotional feelings, as did recovery from delirium. Nurses’ observations of behavioural changes in old patients with impaired cognitive function may be the first step in managing and reducing delirium. The predictive model of delirium ought to be tested further before use in clinical practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 58 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1311
Nursing, delirium, Acute confusional state, hip surgery, hip fracture, replacement surgery, cognitive function, MMSE, Follow-up, health-related quality of life, HRQOL, SF-36, Omvårdnad
National Category
Research subject
Caring Sciences
urn:nbn:se:uu:diva-3814 (URN)91-554-5820-3 (ISBN)
Public defence
2003-12-11, Föreläsningssal 6, Campus Lugnet, Högskolan Dalarna, Falun, 13:00
Available from: 2003-11-18 Created: 2003-11-18Bibliographically approved

Open Access in DiVA

No full text

By organisation
Caring Sciences
In the same journal
Orthopedic Nursing
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 163 hits
ReferencesLink to record
Permanent link

Direct link