Keeping sensory aids in place during surgery reduces delirium risk in older hip fracture patients

Editor's Note

Allowing older surgical patients to keep dentures, glasses, and hearing aids until anesthesia and restoring them immediately afterward significantly lowered postoperative delirium (POD) rates, according to a study published in BMC Geriatrics on August 30.

The prospective before-and-after trial followed patients aged 70 and older undergoing hip fracture repair at a German university hospital. In standard practice, sensory aids were removed upon transfer to the OR and returned only once patients were back on the ward. The intervention group instead received their devices back as soon as they regained consciousness. To manage this process, researchers provided a specialized transport case for secure perioperative storage.

The intervention markedly shortened the median time patients were without their sensory aids, from more than 12 hours to just 12 minutes. This reduction correlated with improved outcomes: POD incidence fell from 65% in the control cohort to 40.5% in the intervention group, a statistically significant difference. Patients also reported higher quality-of-recovery scores during hospitalization, and shorter periods of postoperative monitoring were associated with less time spent without aids. However, length of hospital stay, 30-day mortality, and long-term functional recovery showed no difference between groups.

As detailed in the article, sensory deprivation is a known risk factor for POD, which affects up to half of geriatric hip fracture patients and drives long-term morbidity, mortality, and hospital costs. Preserving sensory input through simple measures such as maintaining hearing and vision aids helps patients stay oriented, communicate with caregivers, and manage stress during the perioperative period.

While the study was limited by its single-center, nonrandomized design and small sample size, the authors emphasize the intervention was low-cost, feasible, and easily integrated into routine care without device loss or complications. They argue that minimizing perioperative sensory impairment should be considered a key element within broader multimodal delirium prevention programs.