Postoperative delirium is a common complication following major surgeries, leading to a variety of adverse effects. However, there is a paucity of literatures studying the incidence and risk factors associated with delirium after primary elective total hip arthroplasty (THA) using a large-scale national database. A retrospective database analysis was performed based on Nationwide Inpatient Sample (NIS) from 2009 to 2014. Patients who underwent primary elective THA were included. Patient demographics, preoperative comorbidities, length of hospital stay (LOS), total charges, in-hospital mortality, and major and minor perioperative complications were evaluated. A total of 388,424 primary elective THAs were obtained from the NIS database, and the general incidence of delirium after THA was 0.90%. Patients with delirium after THA presented more preoperative comorbidities, longer LOS, extra hospital charges, and higher in-hospital mortality rate (P < 0.001). Delirium following THA was associated with major complications during hospitalization including acute renal failure and pneumonia. Preoperative risk factors associated with postoperative delirium included advanced age, alcohol or drug abuse, depression, neurological disorders, psychoses, fluid and electrolyte disorders, diabetes, weight loss, deficiency anemia, coagulopathy, hypertension, congestive heart failure, valvular disease, pulmonary circulation disorders, peripheral vascular disorders, and renal failure. Both female and obesity were detected to be protective factors. The results of our study identified a relatively low incidence of delirium after primary elective THA, which is as reported in the NIS and not necessarily the surgical population as a whole. Postoperative delirium of THA was associated with increased preoperative comorbidities, LOS, total charges, in-hospital mortality, and major perioperative complications including acute renal failure and pneumonia. It is of benefit to study risk factors associated with postoperative delirium to moderate its consequences.

中文翻译：

---

选择性全髋关节置换术后发生following妄的发生率和危险因素：一项回顾性的全国住院患者样本数据库研究。

术后ir妄是大手术后的常见并发症，导致多种不良反应。然而，很少有文献使用大规模的国家数据库来研究初选全髋关节置换术（THA）后ir妄的发生率和危险因素。回顾性数据库分析基于2009年至2014年的全国住院患者样本（NIS）进行。包括接受原发性选择性THA的患者。评估了患者的人口统计资料，术前合并症，住院时间（LOS），总费用，院内死亡率以及围手术期主要和次要并发症。从NIS数据库中总共获得了388,424个主要选修THA，THA后of妄的总发生率为0.90％。THA后出现del妄的患者表现出更多的术前合并症，更长的LOS，额外的住院费用和更高的院内死亡率（P <0.001）。THA后的妄与住院期间的主要并发症有关，包括急性肾衰竭和肺炎。与ir妄术后相关的术前危险因素包括高龄，酗酒或滥用药物，抑郁，神经系统疾病，精神病，液体和电解质紊乱，糖尿病，体重减轻，贫血，凝血病，高血压，充血性心力衰竭，瓣膜疾病，肺循环疾病，周围血管疾病和肾衰竭。女性和肥胖都是保护因素。我们的研究结果表明，初选THA后发生ir妄的可能性相对较低，这是在NIS中报道的，不一定是整个手术人群。术后THA del妄与术前合并症，LOS，总费用，院内死亡率以及围手术期的严重并发症（包括急性肾衰竭和肺炎）增加有关。研究与ir妄相关的危险因素以减轻其后果是有益的。