دورية أكاديمية
أعرض في EDS

The impact of frailty on postoperative delirium in cardiac surgery patients.

التفاصيل البيبلوغرافية
العنوان: The impact of frailty on postoperative delirium in cardiac surgery patients.
المؤلفون: Jung P; University of Manitoba, Winnipeg, Manitoba, Canada., Pereira MA; University of Manitoba, Winnipeg, Manitoba, Canada., Hiebert B; Cardiac Sciences Program, Winnipeg, Manitoba, Canada., Song X; QEII Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada., Rockwood K; QEII Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada., Tangri N; Seven Oaks Hospital and University of Manitoba, Winnipeg, Manitoba, Canada., Arora RC; St Boniface Hospital and University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: rakeshcarora@gmail.com.
المصدر: The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2015 Mar; Vol. 149 (3), pp. 869-75.e1-2. Date of Electronic Publication: 2014 Nov 04.
نوع المنشور: Journal Article; Observational Study; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
مواضيع طبية MeSH: Aging* , Frail Elderly*, Cardiac Surgical Procedures/*adverse effects , Delirium/*etiology, Age Factors ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Delirium/diagnosis ; Delirium/psychology ; Elective Surgical Procedures ; Female ; Geriatric Assessment ; Humans ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Prospective Studies ; Risk Assessment ; Risk Factors ; Surveys and Questionnaires ; Treatment Outcome
مستخلص: Objective: To determine if adding frailty measures to the EuroSCORE II improves model performance in predicting postoperative delirium.
Methods: In a prospective observational study in elective cardiac surgery patients, frailty was defined using the Modified Fried Criteria (MFC), the Short Physical Performance Battery (SPPB) and a 35-item Frailty Index (FI). The primary outcome was postoperative delirium, assessed using the Confusion Assessment Method (CAM).
Results: Seventy-two (54.1%) of the 133 participants met the MFC definition for frailty and 69 (51.9%) met the SPPB definition. Eighty-eight (66.2%) participants had an FI score ≥ 0.2, and 47 (35.3%) had a score ≥ 0.3. After adjusting for the EuroSCORE II, frail patients as identified by the MFC were at increased risk of postoperative delirium (adjusted odds ratio [OR], 5.05, 95% confidence interval [CI], 1.58-16.13). Patients in the "high risk frailty" SPPB category had even greater risk (adjusted OR, 8.26, 95% CI, 2.23-30.64). FI scores ≥ 0.3 were also associated with higher risk of delirium (adjusted OR, 3.72, 95% CI, 1.39-9.92). The inclusion of any of these definitions of frailty improved the discrimination of the EuroSCORE II in predicting postoperative delirium.
Conclusions: Frailty results in a 3- to 8-fold increase in risk of postoperative delirium, independent of the EuroSCORE II. "Frail" and "fit" may be considered 2 ends of a continuum, and the risk of postoperative delirium grows as one becomes increasingly frail. The addition of frailty improves the ability of the EuroSCORE II to predict postoperative delirium, pointing to opportunities for improved prevention and management.
(Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
التعليقات: Comment in: J Thorac Cardiovasc Surg. 2015 Mar;149(3):875-6. (PMID: 25510480)
معلومات مُعتمدة: KPE-12681 Canada Canadian Institutes of Health Research
تواريخ الأحداث: Date Created: 20141210 Date Completed: 20150604 Latest Revision: 20220409
رمز التحديث: 20221213
DOI: 10.1016/j.jtcvs.2014.10.118
PMID: 25486976
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-685X
DOI:10.1016/j.jtcvs.2014.10.118