Maurizio Corsi

Duration of Postoperative Delirium Is an Independent Predictor of 6‐Month Mortality in Older Adults After Hip Fracture

To evaluate the association between number of days with delirium and 6‐month mortality in elderly adults after hip fracture surgery.

Takotsubo cardiomyopathy in an 81-year-old woman after injection of bone cement during hemiarthroplasty: An orthogeriatric case report.

Highlights • Despite the good prognosis when diagnosed early, Takotsubo is a life-threatening event.• Takotsubo must be differentiated from bone cement implantation syndrome (grade 2–3).• A portable ultrasound scanner allows recognizing the apical ballooning and akinesia hallmark.• Approaches to reduce the hospitalization-related stress must be pursued in the elderly.

Effect of the overlap syndrome of depressive symptoms and delirium on outcomes in elderly adults with hip fracture: a comment.

To the Editor: We thank Safer and Kulcu for their valuable comments on our recent article. They made important points about measuring lean body mass using bioimpedance analysis (BIA). In the Korean Longitudinal Study on Health and Aging (KLoSHA), body composition of participants was measured on the same day that blood chemistries, including cholesterol and glucose, were measured after at least 10 hours of overnight fasting. Consequently, we believe that the possible influence on the difference in total body water status from fluid or food intake would have been attenuated. We could not fully investigate the longitudinal change of diuretic use in participants with hypertension, but few participants were taking diuretics for hypertensive monotherapy in the baseline study. Furthermore, a literature search showed that taking diuretics was not associated with a significant difference in water balance in individuals with hypertension, so it is less likely that the possible effect of change in water balance associated with medication could affect the results of our study. The longitudinal association between baseline frailty and change in lean mass was unchanged (odds ratio (OR) = 2.77, 95% confidence interval (CI) = 1.03—7.44 for frail; OR = 1.37, 95% CI = 0.84—2.22 for prefrail) after adjusting for diuretics in Model 3 (table 3). Although BIA was previously cross-validated using magnetic resonance imaging (MRI) in Western populations, it has been validated using dual-energy X-ray absorptiometry rather than computed tomography or magnetic resonance imaging in older Koreans, as Safer and Kulcu noted. Thus, random error might be possible in measuring the lean body mass of individual participants, but this possible random error from measurement method would result in false-negative conclusions (bias toward the null) rather than false-positive conclusions. BIA has many advantages over other methods because it is safe, easy to use, readily reproducible, and appropriate for ambulatory and bedridden individuals. Accordingly, a European and Asian working group on sarcopenia suggested the use of BIA for the measurement of skeletal muscle mass in research and clinical practice. Therefore, ongoing larger community-based studies on frailty and sarcopenia could reinforce the possible longitudinal effect of frailty on lean mass and change in muscle strength.

The impact of psychomotor subtypes and duration of delirium on 6-month mortality in hip-fractured elderly patients

Studies exploring the incidence and impact of the psychomotor subtypes of postoperative delirium (POD) on the survival of hip fracture patients are few, and results are inconsistent. We sought to assess the incidence of POD subtypes and their impact, in addition to delirium duration, on 6‐month mortality in older patients after hip‐fracture surgery.