Delirium in hip fractured patients

The current clinical case concerns the mixed delirium in a 70-year-old man with hip fracture, following a fall at home. In his medical history, the patient reported several comorbidities, among which also sarcopenia. Delirium was already diagnosed by the geriatrician on hospital admission. The patient underwent hip endoprosthesis surgery after 24 hours without any intra-operative complications. However, in the post-operative period delirium persisted, causing a prolonged hospital stay, a delayed physiotherapy rehabilitation with poor functional recovery, and subsequent institutionalization. The prevalence of delirium in older people with hip fracture is extremely high and it is associated with several negative outcomes. Delirium is considered a multifactorial disorder, and, in particular, sarcopenia appears directly linked to the development of delirium. The systematic assessment of sarcopenia should be performed in hospitalized older patients with hip fracture, together with the other predisposing risk factors for delirium, to timely identify people at higher risk for both delirium and disability.