R.Du Hyun RoOrthopedics & Research
Text
Paper Library
TKAperioperative safetydelirium

2026 · Journal of Bone and Joint Surgery American Volume

Are Preoperative Cognitive Function and Psychological Symptoms Associated with Delirium after TKA?

Postoperative delirium occurred in 24/574 patients (4.2%). At MMSE ≤25, sensitivity was 74.5%, specificity 78.3% and AUC 0.834.

Research structure

  1. 01
    Subject

    574 people over the age of 60 with TKA.

  2. 02
    Methods

    Cognitive tests and psychological scales were assessed in a prospective cohort from 2 institutions. Delirium was evaluated with 4AT and CAM on postoperative days 1–5, followed by multivariable regression.

  3. 03
    Reported Results

    Postoperative delirium occurred in 24/574 patients (4.2%). At MMSE ≤25, sensitivity was 74.5%, specificity 78.3% and AUC 0.834.

An explanatory schematic separating the study population, methods, and results. It is not an original paper figure.

Evidence & Original Source

Abstract commentary

Participants and Methods

Cognitive tests and psychological scales were assessed in a prospective cohort from 2 institutions. Delirium was evaluated with 4AT and CAM on postoperative days 1–5, followed by multivariable regression. 574 people over the age of 60 with TKA.

Main Findings

Postoperative delirium occurred in 24/574 patients (4.2%). At MMSE ≤25, sensitivity was 74.5%, specificity 78.3% and AUC 0.834. Independent associations were MMSE OR 0.771 (P = 0.002) and PHQ-15 OR 1.187 (P = 0.028).

The point of reading on surgery

These findings support investigating preoperative cognitive function and somatic symptoms to identify higher-risk patients.

Limitations

With only 24 delirium events, model stability and applicability to other populations require further validation. The study did not assess whether screening reduces delirium.

Let's put it briefly.

What did this study confirm?

Postoperative delirium occurred in 24/574 patients (4.2%). At MMSE ≤25, sensitivity was 74.5%, specificity 78.3% and AUC 0.834.

Can it be applied directly to individual patients' treatment decisions?

With only 24 delirium events, model stability and applicability to other populations require further validation. The study did not assess whether screening reduces delirium.

Keywords

Abstract · Original text

Joon Young Lee, Jee Eun Park, Sung Eun Kim, Byung Sun Choi, Myung Chul Lee, Chong Bum Chang, Hyuk-Soo Han, Hye Youn Park, Du Hyun Ro. Low Cognitive Function and Somatic Psychological Symptoms Are Correlated with Greater Risk of Delirium After Total Knee Arthroplasty: A Prospective Cohort Study. The Journal of bone and joint surgery. American volume. 2026;108(8):584-592. doi:10.2106/JBJS.25.00392.

Excerpt from the original abstract

Postoperative delirium (POD) is a clinically important complication in elderly patients undergoing total knee arthroplasty (TKA) that is associated with prolonged hospitalization, increased morbidity, and…
Read abstract on PubMed

The original paper.

Low Cognitive Function and Somatic Psychological Symptoms Are Correlated with Greater Risk of Delirium After Total Knee Arthroplasty: A Prospective Cohort Study

Joon Young Lee, Jee Eun Park, Sung Eun Kim, Byung Sun Choi, Myung Chul Lee, Chong Bum Chang, Hyuk-Soo Han, Hye Youn Park, Du Hyun Ro
Journal of Bone and Joint Surgery American Volume · 2026 · online 2025

DOI · 10.2106/JBJS.25.00392PubMedBased data
Reviewed academic journal articles