The Association Between Preoperative Frailty and Postoperative Delirium After Cardiac Surgery.
Delirium is common after cardiac surgery, and preoperative identification of high-risk patients could guide prevention strategies. We prospectively measured frailty in 55 patients before cardiac surgery and assessed postoperative delirium using a validated chart review. The prevalence of frailty was 30.9%. Frail patients had a higher incidence of delirium (47.1%) compared with nonfrail patients (2.6%; P < 0.001). In multivariable models, the relative risk of delirium was ≥2.1-fold greater in frail compared with nonfrail patients (relative risk, 18.3; 95% confidence interval, 2.1-161.8; P = 0.009). Frailty may identify patients who would benefit from delirium-prevention strategies because of increased baseline risk for delirium.
From the *Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and †Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; ‡Department of Surgery, University of Manitoba, St. Boniface Hospital, Winnipeg, Mannitoba, Canada; §Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; and ‖Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Charles H
CH
Brown
Laura
L
Max
Andrew
A
LaFlam
Lou
L
Kirk
Alden
A
Gross
Rakesh
R
Arora
Karin
K
Neufeld
Charles W
CW
Hogue
Jeremy
J
Walston
Aliaksei
A
Pustavoitau
D000368:Aged; D015142:Baltimore / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016009:Chi-Square Distribution; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D016330:Frail Elderly; D006304:Health Status; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010865:Pilot Projects; D057216:Propensity Score; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome