Abstract: Objective To investigate the risk factors of postoperative delirium in elderly patients with hip fracture and the nursing strategies. Methods Seventy-four patients with postoperative hip fractures who underwent senile hip fracture between January 2016 and September 2018 were enrolled in the sputum group. One hundred and ninety-eight patients who had no sputum after hip fracture in the elderly were the sputum group. Two groups of gender, previous history of rickets, use of antipsychotic drugs before admission, use of hearing aids, type of fracture, inadequate preoperative preparation, inhalation anesthesia, operation time, postoperative hypoxemia, severe pain after surgery The situation was statistically analyzed, and single factor and multivariate analysis were used to determine the risk factors for postoperative delirium in elderly patients with hip fracture. Results Univariate results showed that previous history of sputum, use of antipsychotic drugs before admission, use of hearing aids, type of fracture, inadequate preoperative preparation, inhalation anesthesia, time of surgery, and presence or absence of hypoxia after surgery hypertension and severe postoperative pain were risk factors for postoperative delirium in elderly patients with hip fracture. Multivariate logistic regression analysis showed that previous history of sputum, use of antipsychotic drugs before admission, use of hearing aids, type of fracture, inadequate preoperative preparation, inhalation anesthesia, time of surgery, and presence or absence of hypoxia after surgery hypertension and severe postoperative pain were risk factors for postoperative delirium in elderly patients with hip fracture. Conclusion The previous history of rickets, use of antipsychotics before admission, use of hearing aids, type of fracture, inadequate preoperative preparation, inhalation anesthesia, time of surgery, postoperative hypoxemia, postoperative severe pain is elderly hip Risk factors for postoperative delirium in patients with fractures, risk factors should be emphasized in the clinic, and treatment and care should be done to prevent postoperative delirium.