Background: Post-operative delirium is a dreaded complication after surgery in older patients. The identification of risk factors for delirium and comprehensive geriatric assessment is an extensive part of recent research. However, the preoperative assessment of risk factors, such as impaired cognition, is frequently not standardized. Methods: A comprehensive preoperative assessment was performed in 421 surgical patients to investigate the impact of preoperative cognitive impairment (PCI) on the risk of delirium and to evaluate appropriate screening tools (Six-item screener (SIS) and clock-drawing test (CDT)). Results: Both screening tools showed a significantly increased risk of delirium with p < 0.001 (OR 12.5, 95% [6.42; 24.4]) in SIS and p = 0.042 (OR 2.02, 95%CI [1.02; 4.03]) in CDT for existing cognitive impairment. A higher level of care (p < 0.001) and statutory care (p < 0.001, OR 5.42, 95%CI [2.34; 12.6]) also proved to be significant risk factors. The ROC curves of the two tests show AUC values of 0.741 (SIS) and 0.630 (CDT). The COP values for the SIS are 4 points with a Youden index of 0.447; for the CDT, the COP is 2 (Youden index = 0.177). Conclusions: The recording of PCI should be a central component of the preoperative geriatric assessment. The tools used are simple yet effective and can be easily implemented in routine clinical practice. By reliably identifying patients at risk, the available resources can be personalized and used in a targeted approach.
机构:
Vet Affairs Tennessee Valley Healthcare Syst, GRECC, Nashville, TN 37212 USA
Vanderbilt Univ, Med Ctr, Dept Med, Div Gen Internal Med & Publ Hlth,Ctr Hlth Serv Re, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Duggan, Maria C.
Pandharipande, Pratik
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Vanderbilt Univ, Med Ctr, Dept Anesthesiol, Div Anesthesiol Crit Care Med, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Pandharipande, Pratik
Girard, Timothy D.
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Univ Pittsburgh, Sch Med, Dept Crit Care Med, Clin Res Invest & Syst Modeling Acute Illness CRI, Pittsburgh, PA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Girard, Timothy D.
Wang, Li
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Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Wang, Li
Thompson, Jennifer L.
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Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Thompson, Jennifer L.
Chandrasekhar, Rameela
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Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Chandrasekhar, Rameela
Francis, Andrew
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机构:
Penn State Med Sch, Hershey Med Ctr, Dept Psychiat, Hershey, PA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Francis, Andrew
Nicolson, Stephen E.
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机构:
Beth Israel Deaconess Hosp Plymouth, Dept Psychiat, Plymouth, MA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Nicolson, Stephen E.
Dittus, Robert S.
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机构:
Vet Affairs Tennessee Valley Healthcare Syst, GRECC, Nashville, TN 37212 USA
Vanderbilt Univ, Med Ctr, Dept Med, Div Pulm & Crit Care, Nashville, TN USA
Vanderbilt Univ, Med Ctr, Ctr Hlth Serv Res, Inst Med & Publ Hlth, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
机构:
Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Xiao, M. Z.
Liu, C. X.
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Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Liu, C. X.
Zhou, L. G.
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Hengyang Med Coll Univ South China, Dept Anat, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Zhou, L. G.
Yang, Y.
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Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Yang, Y.
Wang, Y.
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Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
机构:
Vet Affairs Tennessee Valley Healthcare Syst, GRECC, Nashville, TN 37212 USA
Vanderbilt Univ, Med Ctr, Dept Med, Div Gen Internal Med & Publ Hlth,Ctr Hlth Serv Re, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Duggan, Maria C.
Pandharipande, Pratik
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机构:
Vanderbilt Univ, Med Ctr, Dept Anesthesiol, Div Anesthesiol Crit Care Med, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Pandharipande, Pratik
Girard, Timothy D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Pittsburgh, Sch Med, Dept Crit Care Med, Clin Res Invest & Syst Modeling Acute Illness CRI, Pittsburgh, PA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Girard, Timothy D.
Wang, Li
论文数: 0引用数: 0
h-index: 0
机构:
Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Wang, Li
Thompson, Jennifer L.
论文数: 0引用数: 0
h-index: 0
机构:
Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Thompson, Jennifer L.
Chandrasekhar, Rameela
论文数: 0引用数: 0
h-index: 0
机构:
Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Chandrasekhar, Rameela
Francis, Andrew
论文数: 0引用数: 0
h-index: 0
机构:
Penn State Med Sch, Hershey Med Ctr, Dept Psychiat, Hershey, PA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Francis, Andrew
Nicolson, Stephen E.
论文数: 0引用数: 0
h-index: 0
机构:
Beth Israel Deaconess Hosp Plymouth, Dept Psychiat, Plymouth, MA USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
Nicolson, Stephen E.
Dittus, Robert S.
论文数: 0引用数: 0
h-index: 0
机构:
Vet Affairs Tennessee Valley Healthcare Syst, GRECC, Nashville, TN 37212 USA
Vanderbilt Univ, Med Ctr, Dept Med, Div Pulm & Crit Care, Nashville, TN USA
Vanderbilt Univ, Med Ctr, Ctr Hlth Serv Res, Inst Med & Publ Hlth, Nashville, TN USAVanderbilt Univ, Med Ctr, Dept Psychiat & Behav Sci, 221 Kirkland Hall, Nashville, TN 37235 USA
机构:
Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Xiao, M. Z.
Liu, C. X.
论文数: 0引用数: 0
h-index: 0
机构:
Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Liu, C. X.
Zhou, L. G.
论文数: 0引用数: 0
h-index: 0
机构:
Hengyang Med Coll Univ South China, Dept Anat, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Zhou, L. G.
Yang, Y.
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h-index: 0
机构:
Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China
Yang, Y.
Wang, Y.
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Second Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R ChinaSecond Affiliated Hosp Univ South China, Dept Anesthesiol, Hengyang, Peoples R China