Frailty ups delirium risk in seniors seeking vascular surgery

20 Nov 2020

Frail elderly adults undergoing vascular surgery are more likely to develop hospital-acquired geriatric syndromes, such as delirium, a recent study has found.

Tools to assess frailty, including the Frailty Index (FI) and Clinical Frailty Scale (CFS), may therefore hold good prognostic value for predicting delirium in this population.

A total of 150 elderly patients (mean age, 79.5±7.7 years; 68.0 percent male) admitted to a tertiary vascular surgery unit participated in the study. Primary outcomes were hospital-acquired geriatric syndromes, including delirium, functional decline at discharge, constipation, pressure injuries, and falls.

Among the participants, 34 scored >0.25 on the FI and 45 scored ≥5 on the CFS. These patients were deemed frail, yielding corresponding frailty prevalence rates of 23 percent and 30 percent. On the other hand, 65 percent experienced at least one hospital-acquired geriatric syndrome, of which constipation (53 percent) was the most common. Ten percent of participants developed delirium.

Comparing between subgroups, frail participants as defined by the FI saw significantly higher frequencies of delirium (26.5 percent vs 5.2 percent; p<0.001) and functional decline (33.3 percent vs 14.9 percent; p=0.02) than non-frail counterparts. This was also true for CFS-defined frailty (delirium: 22.2 percent vs 4.8 percent; p=0.001; functional decline: 30.2 percent vs 14.4 percent; p=0.03).

On the other hand, frailty had no significant impact on constipation and falls, and neither did the overall prevalence of any incident hospital-acquired geriatric syndrome vary by frailty status.

However, adjusted multivariate logistic regression models found that frailty, either by FI (odds ratio [OR], 5.64, 95 percent confidence interval [CI], 1.47–21.68) or by CFS (OR, 4.21, 95 percent CI, 1.14–15.50), significantly increased the risk of only incident delirium, and not of functional decline.

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