Association Between Preoperative Nutritional Status and Postoperative Delirium in Older Adults Undergoing Hip and Femur Surgery

Document Type : Original article

Authors

1 Assistant Professor, Nursing and Midwifery Care Research Center, Mashhad University of Medical Science, Mashhad, Iran

2 MSc, Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 MSc Student in Medical-Surgical Nursing, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/nnj.2025.92779.1524

Abstract

Background and Aims: The present study aimed to investigate the association between preoperative nutritional status and postoperative delirium in older adults undergoing hip and femur surgery.
Materials and Methods: This descriptive–analytical cross-sectional study was conducted on 308 older adults aged 65 years and above who were hospitalized for hip and femur fracture surgery in Mashhad teaching hospitals between 2022 and 2024, selected through convenience sampling. Patients with preoperative delirium or those undergoing emergency surgery were excluded. Upon admission, demographic information, comorbidities, disease severity, functional status, depressive symptoms, cognitive function, presence of delirium, and nutritional status were assessed. Postoperative delirium was evaluated at 24 hours, 72 hours, and one week after surgery. Data were analyzed using appropriate statistical tests, with a significance level of 0.05.
Results: In the multivariate logistic regression analysis, factors associated with postoperative delirium included older age, lower hemoglobin level, higher BMI, triglycerides and phosphorus levels, SOFA score >2, psychotropic drug use, and poor nutritional status. The risk of postoperative delirium was significantly higher in patients at risk of malnutrition (OR = 7.13, P = 0.045) and those with overt malnutrition (OR = 10.78, P = 0.014).
Conclusion: Early nutritional assessment and timely intervention may help reduce the risk of postoperative delirium and improve postoperative outcomes in this population.

Keywords

References

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Navid No
Volume 28, Issue 95
November 2025

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