Preoperative frailty vs. cognitive impairment: Which one matters most for postoperative delirium among older adults with cancer?

• Published in: Journal of geriatric oncology 2023-05, Vol.14 (4), p.101479-101479, Article 101479
• Main Authors: Hoffmann, Alexxandra J., Tin, Amy L., Vickers, Andrew J., Shahrokni, Armin
• Format: Article
• Language: English
• Subjects: Aged; Cognitive Dysfunction - complications; Cognitive impairment; Delirium; Frail Elderly; Frailty; Frailty - complications; Frailty - diagnosis; Geriatric Assessment - methods; Geriatric oncology; Humans; Neoplasms - complications; Postoperative Complications - epidemiology; Postoperative Complications - psychology; Retrospective Studies; Risk Factors
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2023.101479

Limited data are available to explore the association between preoperative frailty and cognitive impairment with postoperative delirium among older adults with cancer. We explored this association in a single Comprehensive Cancer Center where postoperative delirium and frailty are assessed in routine care using the Confusion Assessment Method (CAM) and Memorial Sloan Kettering Frailty Index (MSK-FI), respectively. Retrospective study on patients with cancer, aged 65+, who underwent surgery from April 2018 to March 2019 with hospital stay ≥1 day. We used logistic regression with postoperative delirium as the outcome, primary predictor MSK-FI, adjusted for age, operative time, and preoperative albumin. As the MSK-FI includes a component related to cognitive impairment, we additionally evaluated the impact of this component, separately from the rest of the score, on the association between frailty and postoperative delirium. Among 1,257 patients with available MSK-FI and CAM measures, 47 patients (3.7%) had postoperative delirium. Increased frailty was associated with increased risk of postoperative delirium (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.26, 1.81; p