Early Screening for Confusion and Vitamin D Deficiency in Elderly Hip Fracture Patients: A Quality Improvement Initiative to Mitigate the Risk of Postoperative Delirium
2024

Early Screening for Confusion and Vitamin D Deficiency in Elderly Hip Fracture Patients

Sample size: 203 publication Evidence: high

Author Information

Author(s): Muacevic Alexander, Adler John R, Younis Zubair, Gurukiran Gurukiran, Abdullah Faliq, Kumar Sairam, Ford David, Hamid Muhammad A, Wani Kubra Farooq

Primary Institution: Royal Shrewsbury Hospital

Hypothesis

Can routine screening for confusion and vitamin D deficiency in hip fracture patients over 60 identify those at high risk for postoperative delirium?

Conclusion

The quality improvement initiative successfully improved screening compliance for confusion and vitamin D deficiency in elderly hip fracture patients.

Supporting Evidence

  • Baseline compliance with screening was only 27% before the intervention.
  • Post-intervention compliance improved to 52.4%, indicating the effectiveness of the educational intervention.
  • Screening timeliness increased significantly from 51.85% to 83.33% after the intervention.
  • High rates of vitamin D deficiency were observed, emphasizing the need for early detection.
  • AMTS scores correlated with abnormal confusion screens, highlighting cognitive impairment as a risk factor.

Takeaway

This study shows that checking for confusion and vitamin D levels in older patients with hip fractures can help doctors catch problems early and improve care.

Methodology

A two-cycle audit was conducted to assess compliance with confusion and vitamin D screening, followed by an educational intervention to improve adherence.

Potential Biases

The retrospective nature of the study introduces the risk of selection bias due to potentially incomplete records.

Limitations

The study was conducted in a single center, which may limit the applicability of the findings, and it did not assess the direct impact of screenings on clinical outcomes.

Participant Demographics

Elderly patients (aged 60 and above) admitted with hip fractures.

Statistical Information

P-Value

0.0003

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.7759/cureus.75099

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