Question:Both my parents and my mother-in-law have had total hip or total knee replacements. The women were very confused and disoriented after surgery. Is this more common for women than men? If so, does anyone know why this happens?
Answer:Confusion or disorientation after surgery of any kind may be a neurologic problem called postoperative delirium. Agitation and disorganized thoughts are part of this problem. Women are not necessarily at greater risk for delirium. The most significant risk factor is older age. Since women outlive men two to one, older adults are more often women than men.
Other factors that put patients at risk include poor mental health or decreased physical fitness. The use of alcohol or other drugs is a greater problem among older adults than often realized. Withdrawal from alcohol and other drugs can also bring on periods of confusion and/or delirium.
Certain medications such as narcotic pain relievers and antidepressants may be another risk factor. Dehydration, lack of oxygen, and immobility are common risk factors for delirium among older adults.
Doctors are being encouraged to prevent postoperative neurologic symptoms like confusion and delirium. Assessing patients' physical condition and mental status before surgery is an important part of reducing these problems.Daniel T. Alfonso, MD, et al. Nonsurgical Complications After Total Hip and Knee Arthroplasty. In The American Journal of Orthopedics. November 2006. Vol. 35. No. 11. Pp. 503-511.
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