TY - JOUR
T1 - Postoperative Delirium Following Joint Replacement in Patients With Dementia in New South Wales, Australia A State-Wide Retrospective Cohort Study
AU - Li, Xi
AU - Du, Wei
AU - Parkinson, Anne
AU - Glasgow, Nicholas
N1 - Funding Information:
The authors have disclosed no potential conflicts of interest, financial or otherwise.This work was supported by an Australian National Health and Medical Research Council Senior Research Fellowship (#1058878).The study sponsors had no further role in the study design, data collection, statistical analyses,interpretation of results,writing of the article,or the decision to submit it for publication. The authors thank the NSW Department of Health for providing the Admitted Patient Data Collection data. Address correspondence to Xi Li, MPH, PhD Student, Centre for Research and Action in Public Health, Building 22, University Drive, University of Canberra, Bruce ACT 2601, Australia; e-mail: xi.li@canberra.edu.au. Received: June 15,2019; Accepted: October 16,2019 doi:10.3928/19404921-20200214-01
Funding Information:
The authors have disclosed no potential conflicts of interest, financial or otherwise. This work was supported by an Australian National Health and Medical Research Council Senior Research Fellowship (#1058878). The study sponsors had no further role in the study design, data collection, statistical analyses, interpretation of results, writing of the article, or the decision to submit it for publication. The authors thank the NSW Department of Health for providing the Admitted Patient Data Collection data.
Publisher Copyright:
© SLACK Incorporated.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - The objective of the current study was to investigate the variation in postoperative delirium in patients with dementia undergoing joint replacement in New South Wales (NSW) Australia public hospitals, identify factors related to its occurrence, and explore the volume-outcome relationship. The NSW Admitted Patient Data (July 2001 to June 2014) were used in this study and included patients with dementia undergoing joint replacement who were 65 or older with minor to severe comorbidities. Mixed-effect logistic models were applied to investigate hospital-level variation and factors associated with postoperative delirium. The between-hospital variability of postoperative delirium was 0.19% prior to 2008-2009 and 8.32% after 2008-2009. Hospital volume was not inversely associated with postoperative delirium rate. During 2001-2014, the incidence of postoperative delirium increased by 13% per annum (95% confidence interval [CI] 10% to 16%), while it increased by 15% per annum (95% CI 8% to 22%) after 2008-2009. An integrated approach addressing complex needs of patients with dementia may reduce the observed unwarranted variation and improve surgical outcomes.
AB - The objective of the current study was to investigate the variation in postoperative delirium in patients with dementia undergoing joint replacement in New South Wales (NSW) Australia public hospitals, identify factors related to its occurrence, and explore the volume-outcome relationship. The NSW Admitted Patient Data (July 2001 to June 2014) were used in this study and included patients with dementia undergoing joint replacement who were 65 or older with minor to severe comorbidities. Mixed-effect logistic models were applied to investigate hospital-level variation and factors associated with postoperative delirium. The between-hospital variability of postoperative delirium was 0.19% prior to 2008-2009 and 8.32% after 2008-2009. Hospital volume was not inversely associated with postoperative delirium rate. During 2001-2014, the incidence of postoperative delirium increased by 13% per annum (95% confidence interval [CI] 10% to 16%), while it increased by 15% per annum (95% CI 8% to 22%) after 2008-2009. An integrated approach addressing complex needs of patients with dementia may reduce the observed unwarranted variation and improve surgical outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85090845542&partnerID=8YFLogxK
U2 - 10.3928/19404921-20200214-01
DO - 10.3928/19404921-20200214-01
M3 - Other Journal Article
VL - 13
SP - 243
EP - 261
JO - Research In Gerontological Nursing
JF - Research In Gerontological Nursing
SN - 1938-2464
IS - 5
ER -