Affiliation:
1. School of Nursing Jinan University Guangzhou China
2. Department of Clinical Research The First Affiliated Hospital of Jinan University Guangzhou China
3. Department of Neurology The First Affiliated Hospital of Jinan University Guangzhou China
4. School of Public Health Shanxi University of Chinese Medicine Xianyang China
5. Department of Infectious Diseases and Public Health City University of Hong Kong Hong Kong China
6. Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization Guangzhou China
Abstract
AbstractAimTo evaluate the association between frailty and postoperative delirium (POD) in elderly cardiac surgery patients.MethodsA retrospective study was conducted of older patients admitted to the intensive care unit after cardiac surgery at a tertiary academic medical center in Boston from 2008 to 2019. Frailty was measured using the Modified Frailty Index (MFI), which categorized patients into frail (MFI ≥3) and non‐frail (MFI = 0–2) groups. Delirium was identified using the confusion assessment method for the intensive care unit and nursing notes. Logistic regression models were used to examine the association between frailty and POD, and odds ratios (OR) with 95% confidence intervals (CI) were calculated.ResultsOf the 2080 patients included (median age approximately 74 years, 30.9% female), 614 were frail and 1466 were non‐frail. The incidence of delirium was significantly higher in the frail group (29.2% vs. 16.4%, p < 0.05). After adjustment for age, sex, race, marital status, Acute Physiology Score III (APSIII), sequential organ failure assessment (SOFA), albumin, creatinine, hemoglobin, white blood cell count, type of surgery, alcohol use, smoking, cerebrovascular disease, use of benzodiazepines, and mechanical ventilation, multivariate logistic regression indicated a significantly increased risk of delirium in frail patients (adjusted OR: 1.61, 95% CI: 1.23–2.10, p < 0.001, E‐value: 1.85).ConclusionsFrailty is an independent risk factor for POD in older patients after cardiac surgery. Further research should focus on frailty assessment and tailored interventions to improve outcomes.