Frailty Indicator as Predictor for Postoperative Delirium after Vascular Surgery: A Prospective Cohort Study

Perioperative Considerations


Standardised Frailty Indicator as Predictor for Postoperative Delirium after Vascular Surgery: A Prospective Cohort Study


Pol RA, van Leeuwen BL, Visser L, et al (Univ of Groningen, The Netherlands) Eur J Vasc Endovasc Surg 42:824–830, 2011§



G.L. Moneta, MD



Evidence Ranking


• C



Expert Rating


• 1



Abstract



Objectives


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.

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Apr 1, 2017 | Posted by in CARDIOLOGY | Comments Off on Frailty Indicator as Predictor for Postoperative Delirium after Vascular Surgery: A Prospective Cohort Study

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