title: Standardised frailty indicator as predictor for postoperative delirium after vascular surgery: a prospective cohort study.
abstract: OBJECTIVE
  To determine whether the Groningen Frailty Indicator (GFI) has a positive predictive value for postoperative delirium (POD) after vascular surgery.
  
  
  METHODS
  Between March and August 2010, 142 consecutive vascular surgery patients were prospectively evaluated. Preoperatively, the GFI was obtained and postoperatively patients were screened with the Delirium Observation Scale (DOS). Patients with a DOS-score ≥3 points were assessed by a geriatrician. Delirium was defined by the DSM-IV-TR criteria. Primary outcome variable was the incidence of POD. Secondary outcome variables were any surgical complication and hospital length of stay (HLOS) (>7 days).
  
  
  RESULTS
  Ten patients (7%) developed POD. The highest incidence of POD was found after aortic surgery (17%) and amputation procedures (40%). Increased comorbidities (p = 0.006), GFI score (p = 0.03), renal insufficiency (p = 0.04), elevated C-reactive protein (p = 0.008), high American Society of Anaesthesiologists score (p = 0.05), a DOS-score of ≥3 points (p = 0.001), post-operative intensive care unit admittance (p = 0.01) and HLOS ≥7 days (p = 0.005) were risk factors for POD. The GFI score was not associated with a prolonged HLOS. A mean number of 2 ± 1 (range 0-5) complications were registered. The receiver operator characteristics (ROC) area under the curve for the GFI was 0.70.
  
  
  CONCLUSIONS
  The GFI can be helpful in the early identification of POD after vascular surgery in a select group of high-risk patients.
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: R A
authors.initials: RA
authors.lastname: Pol
authors.forename: B L
authors.initials: BL
authors.lastname: van Leeuwen
authors.forename: L
authors.initials: L
authors.lastname: Visser
authors.forename: G J
authors.initials: GJ
authors.lastname: Izaks
authors.forename: J J A M
authors.initials: JJ
authors.lastname: van den Dungen
authors.forename: I F J
authors.initials: IF
authors.lastname: Tielliu
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003693:Delirium / Q000209:etiology*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D014652:Vascular Diseases / Q000601:surgery*; D055815:Young Adult