Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2020; 11(2): 90-106
Published online Feb 18, 2020. doi: 10.5312/wjo.v11.i2.90
Postoperative delirium after major orthopedic surgery
Michael K Urban, Mayu Sasaki, Abigail M Schmucker, Steven K Magid
Michael K Urban, Department of Anesthesiology, Hospital for Special Surgery, New York, NY 10021, United States
Michael K Urban, Steven K Magid, Weill Cornell Medical College, New York, NY 10065, United States
Mayu Sasaki, Quality Research Center, Hospital for Special Surgery, New York, NY 10021, United States
Abigail M Schmucker, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA 19107, United States
Steven K Magid, Department of Rheumatology, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: Urban MK and Magid SK contributed to study conception and design; Sasaki M and Schmucker AM contributed to data acquisition and data analysis; Urban MK and Sasaki M contributed to the interpretation and writing of the article; Urban MK, Sasaki M, Schmucker AM and Magid SK contributed to editing, reviewing and final approval of the article.
Institutional review board statement: All human subject research conducted during the course of this study was approved by the Hospital for Special Surgery Institutional Review Board.
Informed consent statement: This study could not practicably be carried out without the waiver of HIPAA authorization since patients were not scheduled to return for follow-up. A waiver of documentation of informed consent according to 45 CFR 46.117(c) and a waiver of HIPAA authorization in accordance with 45 CRF 164.512(i) was obtained prior to the start of study activities.
Conflict-of-interest statement: Each author certifies that Sasaki M has received research support funding from Susan and Elihu Rose Foundation. Each author certifies that Schmucker AM has received research support funding from Susan and Elihu Rose Foundation.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Michael K Urban, MD, PhD, Attending Doctor, Director, Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States. urbanm@hss.edu
Received: July 24, 2019
Peer-review started: July 24, 2019
First decision: October 24, 2019
Revised: November 7, 2019
Accepted: November 28, 2019
Article in press: November 28, 2019
Published online: February 18, 2020
Processing time: 209 Days and 18.8 Hours
Core Tip

Core tip: This original research adds significantly to the perioperative literature. At this single orthopedic institution, the effects of different procedures, and effects of the different management practices of these procedures, on postoperative delirium were examined. The incidence of post-operative delirium was found to be lower at this institution than many other previous reports. Potentially modifiable risk factors for post-operative delirium in patients undergoing common orthopedic procedures, for whom higher vigilance is warranted were also identified.