Effect of a single pre-operative 125 mg dose of methylprednisolone on postoperative delirium in hip fracture patients; a randomised, double-blind, placebo-controlled trial

Anaesthesia
C G ClemmesenN B Foss

Abstract

Postoperative delirium is common after hip fracture surgery, and may have a neuro-inflammatory cause. We conducted a single-centre, randomised, double-blind, placebo-controlled trial of 117 older hip fracture patients to see if a single, pre-operative intravenous dose of 125 mg methylprednisolone could reduce the severity and/or incidence of postoperative delirium, assessed using the Confusion Assessment Method delirium severity score. Modified intention-to-treat analysis found no significant difference in our primary outcome, median (IQR [range]) cumulative Confusion Assessment Method delirium severity score over the first three postoperative days between the methylprednisolone and placebo groups (1 (0-6 [0-39]) vs. 2 (0-10 [0-32]), p = 0.294). Both the prevalence of postoperative delirium (Confusion Assessment Method delirium severity score ≥ 5, 10/59 vs. 19/58, p = 0.048) and the median (IQR [range]) cumulated postoperative (by day 3) fatigue scores (5 (2-6 [0-11]) vs. 6 (4-8 [0-16]), p = 0.008) were significantly lower in the methylprednisolone compared with the placebo group. There were no significant between-group differences in the rate of completing physiotherapy, postoperative pain, the administration of antipsychotic ...Continue Reading

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Citations

Sep 10, 2020·Journal of the American Geriatrics Society·Beatriz León-SalasPedro Serrano-Aguilar
Jan 7, 2020·Anaesthesia·N B Foss, H Kehlet
Apr 20, 2019·Evidence-based Complementary and Alternative Medicine : ECAM·Yong LiuYan Kang
Jul 19, 2020·Archives of Gerontology and Geriatrics·Beatriz León-SalasPedro Serrano-Aguilar
Apr 6, 2021·Anaesthesia·D Abraham, M D Neuman
Aug 24, 2021·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Xiao-Bing XiangXin-Qi Cheng
Jan 11, 2022·Anaesthesia·J K Dhesi, I K Moppett
Jan 11, 2022·Anaesthesia·L White, T Jackson

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