{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:13:26Z","timestamp":1788459206980,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Geriatric trauma centers (ATZ) in Germany provide interdisciplinary care for elderly trauma patients with the objective of enhancing treatment outcomes following proximal femur fractures. Delirium, a prevalent and grave complication in this patient population, has been associated with elevated mortality and functional limitations. The objective of this study was to examine the prevalence and consequences of delirium in proximal femur fractures by utilizing the Registry for Geriatric Trauma (ATR-DGU). Methods: The study encompassed 32,934 patients aged \u226570 years who sustained proximal femoral fractures during the period 2022\u20132023. The demographic and clinical parameters, fracture type, time of surgery, mobility, complications, and mortality were meticulously documented. The primary endpoint of the study was the occurrence of delirium and its influence of the outcome of hip fracture patients. Additionally an analysis was conducted to account for peri-implant\/periprosthetic fractures. Results: Of the 21,127 patients who underwent screening, 23.6% had already been diagnosed with delirium upon admission. The delirium rate did not differ between hip-\/pertrochanteric and peri-implant\/periprosthetic fractures. Patients in a delirious state were found to be older, frailer, and more dependent on care. They exhibited more non-surgical complications, poorer mobility, and more frequent transfers to nursing homes. In the context of peri-implant\/periprosthetic fractures, delirium showed no significant difference regarding surgical revision (p = 0.192) and mortality rates (p = 0.229). Conclusions: Delirium is therefore a prevalent and clinically significant complication. Its early detection and prevention are essential for proximal femur fracture patients in orthogeriatric care.<\/jats:p>","DOI":"10.3390\/jcm15176842","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:13:25Z","timestamp":1788455605000},"page":"6842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Outcome of Delirium in Proximal Femur Fracture Patients Undergoing Orthogeriatric Treatment"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0186-3800","authenticated-orcid":false,"given":"Vanessa","family":"Ketter","sequence":"first","affiliation":[{"name":"Helios Kliniken Kassel, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Benjamin","family":"Buecking","sequence":"additional","affiliation":[{"name":"Helios Kliniken Kassel, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"given":"Daphne Asimenia","family":"Eschbach","sequence":"additional","affiliation":[{"name":"Helios Kliniken Kassel, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Alterk","sequence":"additional","affiliation":[{"name":"Helios Kliniken Kassel, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"given":"Steffen","family":"Ruchholtz","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Philipps-University Marburg, Location Marburg, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5633-1616","authenticated-orcid":false,"given":"Carsten","family":"Schoeneberg","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Bastian","family":"Pass","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Emergency Surgery, Alfried Krupp Hospital, Hellweg 100, 45276 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4934-2206","authenticated-orcid":false,"given":"Hannah","family":"Schmidt","sequence":"additional","affiliation":[{"name":"AUC\u2014Academy for Trauma Surgery, 80538 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Tom","family":"Knauf","sequence":"additional","affiliation":[{"name":"Helios Kliniken Kassel, 34121 Kassel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","first-page":"101","article-title":"Acute Confusional States in Hospital","volume":"116","author":"Zoremba","year":"2019","journal-title":"Dtsch. \u00c4rztebl. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1007\/s11657-019-0586-1","article-title":"Predictors of long-term survival after hip fractures?-5-year results of a prospective study in Germany","volume":"14","author":"Knauf","year":"2019","journal-title":"Arch. Osteoporos."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2151459320949476","DOI":"10.1177\/2151459320949476","article-title":"Orthogeriatric Trauma Unit Improves Patient Outcomes in Geriatric Hip Fracture Patients","volume":"11","author":"Schuijt","year":"2020","journal-title":"Geriatr. Orthop. Surg. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1055\/s-2004-828361","article-title":"Inzidenz und Risikofaktoren eines Delirs nach H\u00fcftoperation","volume":"31","author":"Bickel","year":"2004","journal-title":"Psychiatr. Prax."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1159\/000442385","article-title":"Prevalence and Characteristics of Pre-Operative Delirium in Hip Fracture Patients","volume":"62","author":"Freter","year":"2016","journal-title":"Gerontology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s40520-018-0985-y","article-title":"Surgical delay is a risk factor of delirium in hip fracture patients with mild-moderate cognitive impairment","volume":"31","author":"Pioli","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0167-4943(02)00058-4","article-title":"The unfavorable nature of preoperative delirium in elderly hip fractured patients","volume":"36","author":"Adunsky","year":"2003","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e1863","DOI":"10.1002\/msc.1863","article-title":"Early mobilisation after hip fracture surgery is associated with improved patient outcomes: A systematic review and meta-analysis","volume":"22","author":"Agarwal","year":"2024","journal-title":"Musculoskelet. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1046\/j.1532-5415.2001.49261.x","article-title":"Delirium before and after operation for femoral neck fracture","volume":"49","author":"Edlund","year":"2001","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1007\/s00198-021-05974-8","article-title":"Orthogeriatric co-management reduces incidence of delirium in hip fracture patients","volume":"32","author":"Pollmann","year":"2021","journal-title":"Osteoporos. Int."},{"key":"ref_11","unstructured":"(2026, August 31). Umfassendes Geriatrisches Assessment (Comprehensive Geriatric Assessment, CGA) bei Hospitalisierten Patientinnen und Patienten S3-Leitlinie der Deutschen Gesellschaft f\u00fcr Geriatrie (DGG). Available online: https:\/\/register.awmf.org\/assets\/guidelines\/084-003l_S3_Umfassendes-Geriatrisches-Assessment-Comprehensive-Geriatric-Assessment-CGA-bei-hospitalisierten-PatientInnen_2024-06.pdf."},{"key":"ref_12","first-page":"CD012485","article-title":"Comprehensive geriatric as-sessment for older people admitted to a surgical service","volume":"2018","author":"Eamer","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1111\/jgs.14846","article-title":"Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials","volume":"65","author":"Shields","year":"2017","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_14","first-page":"CD005563","article-title":"Interventions for preventing de-lirium in hospitalised non-ICU patients","volume":"2016","author":"Siddiqi","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"960364","DOI":"10.3389\/fnagi.2022.960364","article-title":"Risk factors for postoperative delirium in geriatric patients with hip fracture: A systematic review and meta-analysis","volume":"14","author":"Qi","year":"2022","journal-title":"Front Aging Neurosci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1002\/gps.4233","article-title":"Preoperative risk factors for postoperative delirium following hip fracture repair: A systematic review","volume":"30","author":"Oh","year":"2015","journal-title":"Int. J. Geriat Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1302\/0301-620X.107B4.BJJ-2024-1164.R1","article-title":"Delirium on presentation with a hip fracture is associated with adverse outcomes: A multicentre observational study of 18,040 patients using national clinical registry data","volume":"107","author":"Penfold","year":"2025","journal-title":"Bone Jt. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jclinane.2019.08.015","article-title":"The association of preoperative delirium with postoperative outcomes following hip surgery in the elderly","volume":"60","author":"Agrawal","year":"2020","journal-title":"J. Clin. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e20-00221","DOI":"10.5435\/JAAOSGlobal-D-20-00221","article-title":"Predictors and Sequelae of Postoperative Delirium in a Geriatric Patient Population with Hip Fracture","volume":"5","author":"Haynes","year":"2021","journal-title":"JAAOS Glob. Res. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1111\/j.1532-5415.2009.02377.x","article-title":"Risk Factors for Preoperative and Postoperative Delirium in Elderly Patients with Hip Fracture","volume":"57","author":"Krogseth","year":"2009","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s41999-021-00456-w","article-title":"Post-operative delirium in older hip fracture patients: A new onset or was it already there?","volume":"12","author":"Carreteiro","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_22","first-page":"53","article-title":"The Association Between Orthogeriatric Co-Management and Mortality Following Hip Fracture","volume":"117","author":"Rapp","year":"2020","journal-title":"Dtsch. \u00c4rztebl. Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1302\/2633-1462.67.BJO-2024-0243.R1","article-title":"A systematic review of evidence regarding the association between time to mobilization following hip fracture surgery and patient outcomes","volume":"6","author":"Ting","year":"2025","journal-title":"Bone Jt. Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s11657-021-00930-9","article-title":"Four-month outcome after proximal femur fractures and influence of early geriatric rehabilitation: Data from the German Centres of Geriatric Trauma DGU","volume":"16","author":"Schoeneberg","year":"2021","journal-title":"Arch. Osteoporos."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6842\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:21:26Z","timestamp":1788456086000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":24,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176842"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176842","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}