Donglin Fu1, Xiaoyu Tan2, Meng Zhang1, Liang Chen1, Jin Yang3. 1. Intensive Care Unit, Chongqing General Hospital, University of Chinese Academy of Sciences, No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing, 400010, China. 2. Department of Urology, Chongqing University Central Hospital, Chongqing, 400010, China. 3. Intensive Care Unit, Chongqing General Hospital, University of Chinese Academy of Sciences, No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing, 400010, China. yangjin_3233@sina.com.
Abstract
BACKGROUND: Frailty has been suggested as a possible risk factor for postoperative delirium (POD). However, results of previous studies were not consistent. We performed a meta-analysis of cohort study to evaluate the above association. METHODS: Relevant studies were obtained via systematic search of PubMed, Embase, SCOPUS, and Web of Science databases. Only studies with multivariate analysis were included. A random-effect model incorporating the potential heterogeneity was used to combine the results. RESULTS: Fifteen cohort studies including 3250 adult patients who underwent surgery were included, and the prevalence of frailty was 27.1% (880/3250) before surgeries. Overall, POD occurred in 513 patients (15.8%). Pooled results showed that frailty was associated with a higher risk of POD (adjusted odds ratio [OR]: 3.23, 95% confidence interval [CI]: 2.56-4.07, P < 0.001) without significant heterogeneity (P for Cochrane's Q test = 0.25, I2 = 18%). Subgroup analyses showed a more remarkable association between frailty and POD in prospective cohort studies (OR: 3.64, 95% CI: 2.95-4.49, P < 0.001) than that in retrospective cohort studies (OR: 2.32, 95% CI: 1.60-3.35, P < 0.001; P for subgroup difference = 0.04). Moreover, the association was not affected by country of the study, age group of the patient, elective or emergency surgeries, cardiac and non-cardiac surgeries, evaluation instruments for frailty, diagnostic methods for POD, or quality score of the study (P for subgroup difference all > 0.05). CONCLUSIONS: Frailty may be associated with a higher risk of POD in adult population.
BACKGROUND: Frailty has been suggested as a possible risk factor for postoperative delirium (POD). However, results of previous studies were not consistent. We performed a meta-analysis of cohort study to evaluate the above association. METHODS: Relevant studies were obtained via systematic search of PubMed, Embase, SCOPUS, and Web of Science databases. Only studies with multivariate analysis were included. A random-effect model incorporating the potential heterogeneity was used to combine the results. RESULTS: Fifteen cohort studies including 3250 adult patients who underwent surgery were included, and the prevalence of frailty was 27.1% (880/3250) before surgeries. Overall, POD occurred in 513 patients (15.8%). Pooled results showed that frailty was associated with a higher risk of POD (adjusted odds ratio [OR]: 3.23, 95% confidence interval [CI]: 2.56-4.07, P < 0.001) without significant heterogeneity (P for Cochrane's Q test = 0.25, I2 = 18%). Subgroup analyses showed a more remarkable association between frailty and POD in prospective cohort studies (OR: 3.64, 95% CI: 2.95-4.49, P < 0.001) than that in retrospective cohort studies (OR: 2.32, 95% CI: 1.60-3.35, P < 0.001; P for subgroup difference = 0.04). Moreover, the association was not affected by country of the study, age group of the patient, elective or emergency surgeries, cardiac and non-cardiac surgeries, evaluation instruments for frailty, diagnostic methods for POD, or quality score of the study (P for subgroup difference all > 0.05). CONCLUSIONS: Frailty may be associated with a higher risk of POD in adult population.
Authors: Mark James Rawle; Laura McCue; Elizabeth L Sampson; Daniel Davis; Victoria Vickerstaff Journal: Drugs Aging Date: 2021-01-08 Impact factor: 3.923
Authors: Elijah Blue Dahlstrom; Jin Ho Han; Heather Healy; Maura Kennedy; Glenn Arendts; Jacques Lee; Chris Carpenter; Sangil Lee Journal: BMJ Open Date: 2020-10-06 Impact factor: 2.692