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Association between frailty and postoperative delirium: a meta-analysis of cohort study

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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.

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Authors and Affiliations

  1. Intensive Care Unit, Chongqing General Hospital, University of Chinese Academy of Sciences, No. 118 Xingguang Avenue, Liangjiang New Area, Chongqing, 400010, China

    Donglin Fu, Meng Zhang, Liang Chen & Jin Yang

  2. Department of Urology, Chongqing University Central Hospital, Chongqing, 400010, China

    Xiaoyu Tan

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  1. Donglin Fu
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  2. Xiaoyu Tan
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  3. Meng Zhang
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  4. Liang Chen
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Contributions

DF and JY designed the study; DF and XT performed literature search, study identification, and data extraction; DF, MZ and LC performed statistics; DF drafted the manuscript; JY critically reviewed the manuscript. All authors approved the submission.

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Correspondence to Jin Yang.

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Fu, D., Tan, X., Zhang, M. et al. Association between frailty and postoperative delirium: a meta-analysis of cohort study. Aging Clin Exp Res 34, 25–37 (2022). https://doi.org/10.1007/s40520-021-01828-9

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