Predictive Value of the Duke Anesthesia Resistance Scale in Postoperative Delirium among Elderly Patients with Hip Fractures.

Abstract

Objective: This study aimed to investigate the predictive value of the Duke Anesthesia Resistance Scale (DARS) for postoperative delirium in elderly patients following hip fracture surgery.

Methods: A retrospective study was conducted on 90 elderly patients with hip fractures who underwent surgical treatment from January 2018 to January 2021. Patients were categorized into delirium (n=22) and non-delirium (n=68) groups based on postoperative delirium occurrence. Qualitative and quantitative variables were compared between the groups to identify primary risk factors for postoperative delirium. The ability of DARS to predict postoperative delirium was assessed using the receiver operating characteristic (ROC) curve.

Results: Significant differences in age, number of underlying diseases, surgical blood loss, and DARS scores were observed between the delirium and non-delirium groups (P < .05). Multivariate logistic regression analysis indicated that DARS scores (OR=2.321), age (OR=2.476), number of underlying diseases (OR=2.209), surgical blood loss (OR=2.267), and postoperative pain (OR=2.287) were significant predictors of postoperative delirium (P < .05). Pearson correlation analysis revealed a negative correlation between DARS scores and age, number of underlying diseases, and surgical blood loss (P < .05). The ROC curve analysis demonstrated that the area under the curve (AUC) for DARS in predicting postoperative delirium was 0.8255 (95% CI: 0.726~0.924). At a DARS cutoff score of 38, the specificity was 80.28%, and the sensitivity was 81.45%.

Conclusion: The DARS score is a valuable tool for predicting postoperative delirium in elderly patients with hip fractures, with an optimal threshold of 38 points. The use of DARS in predicting postoperative delirium could significantly benefit healthcare providers and improve patient care.