Leung; Tsai; Sands, 20111919. Leung JM, Tsai TL, Sands LP. Brief report: preoperative frailty in older surgical patients is associated with early postoperative delirium. Anesth Analg. 2011;112(5):1199-201. Doi: 10.1213/ANE.0b013e31820c7c06 https://doi.org/10.1213/ANE.0b013e31820c...
|
USA |
Surgical, non-cardiac. |
To investigate if preoperative frailty in surgical non-cardiac patients favors onset of postoperative delirium. |
63 |
Prospective cohort study |
>65 years old |
Modified Fried Criteria |
CAM†
|
Prevalence of frailty HR‡ 0.33 (0.23 - 0.45) Prevalence of delirium HR‡ 0.25 (0.16 - 0.37) Risk of delirium in frail patients RR§ 2.57 (1.11 - 5.94) |
Eeles, et al., 20122020. Eeles EMP, White SV, O'Mahony SM, Bayer AJ, Hubbard RE. The impact of frailty and delirium on mortality in older inpatients. Age Ageing. 2012;41(3);412-6. Doi: 10.1093/ageing/afs021 https://doi.org/10.1093/ageing/afs021...
|
Australia |
Acute care, general hospital |
To explore the relationship between delirium and frailty in aged patients and to determine their impact on survival. |
273 |
Prospective cohort study |
82.3±7.5 |
FI|| (33 items) (Frail>0.25) |
DSM-5¶
|
Prevalence of frailty HR‡ 0.41 (0.35 - 0.47) Prevalence of delirium HR‡ 0.37 (0.31 - 0.43) Risk of delirium in frail patients RR§ 3.62 (2.54 - 5.18) |
Joosten, et al., 20142121. Joosten E, Demuynck M, Detroyer E, Milisen K. Prevalence of frailty and its ability to predict in hospital delirium, falls, and 6-month mortality in hospitalized older patients. BMC Geriatr. 2014;14:1. Doi: 10.1186/1471-2318-14-1 https://doi.org/10.1186/1471-2318-14-1...
|
Belgium |
Geriatric ward |
To evaluate the prevalence of frailty and to determine to which extent it predicts delirium, falls and mortality in hospitalized aged patients. |
220 |
Prospective cohort study |
CHS**: Frail 83.3±5.4 SOF††: 83.1±5.2 |
CHS** and SOF††
|
CAM†
|
Prevalence of frailty HR‡ 0.40 (0.34 - 0.47) Prevalence of delirium HR‡ 0.11 (0.08 - 0.16) Risk of delirium in frail patients RR§ 1.07 (0.50 - 2.30) |
Hempenius, et al., 20142222. Hempenius L, Slaets JP, van Asselt DZ, Schukking J, de Bock GH, Wiggers T, et al. Interventions to prevent postoperative delirium in elderly cancer patients should be targeted at those undergoing nonsuperficial surgery with special attention to the cognitive impaired patients. Eur J Surg Oncol. 2015;41(1):28-33. Doi: 10.1016/j.ejso.2014.04.006 https://doi.org/10.1016/j.ejso.2014.04.0...
|
Netherlands |
Surgery, solid tumors |
To determine the risk factors for postoperative delirium (POD) in aged patients with cancer. |
251 |
Multicenter and retrospective cohort study |
74.2±6.4 (65 - 92) |
Groningen Frailty Indicator |
CAM†
|
Prevalence of frailty HR‡ 0.34 (0.23 - 0.34) Prevalence of delirium HR‡ 0.18 (0.14 - 0.24) Risk of delirium in frail patients RR§ 2.01 (1.20 - 2.37) |
Eide, et al., 20152323. Eide LSP, Ranhoff AH, Fridlund B, Haaverstad R, Hufthammer KO, Kuiper KKJ, et al. Comparison of frequency, risk factors, and time course of postoperative delirium in octogenarians after transcatheter aortic valve implantation versus surgical aortic valve replacement. Am J Cardiol. 2015;115(6):802-9. Doi: 10.1016/j.amjcard.2014.12.043 https://doi.org/10.1016/j.amjcard.2014.1...
|
Norway |
Cardiac Surgery |
To determine the incidence of postoperative delirium in people aged 80-89 years old subjected to TAVI‡‡ or to aortic valve surgical replacement; to identify risk factors and describe possible differences at onset and progression of postoperative delirium between the groups. |
143 |
Prospective cohort study |
> 80 83.5±2.7 |
SOF††
|
CAM†
|
Prevalence of frailty HR‡ 0.39 (0.31 - 0.47) Prevalence of delirium HR‡ 0.42 (0.34 - 0.50) Risk of delirium in frail patients RR§ 1.14 (0.85 - 1.53) |
Partridge, et al., 20152424. Partridge JS, Fuller M, Harari D, Taylor PR, Martin FC, Dhesi JK. Frailty and poor functional status are common in arterial vascular surgical patients and affect postoperative outcomes. Int J Surg. 2015;18:57-63. Doi: 10.1016/j.ijsu.2015.04.037 https://doi.org/10.1016/j.ijsu.2015.04.0...
|
United Kingdom |
Elective and emergency arterial-vascular surgeries |
To evaluate the prevalence of frailty, clinical conditions and functional status in preoperative among older adults undergoing arterial vascular surgery and to evaluate postoperative outcomes. |
125 |
Prospective cohort study |
76.3±7.27 |
EFS§§ (Frail≥6.5) |
Not reported |
Prevalence of frailty HR‡ 0.52 (0.43 - 0.61) Prevalence of delirium HR‡ 0.15 (0.10 - 0.22) Risk of delirium in frail patients RR§ 0.27 (0.17 - 0.43) |
Nguyen; Cumming; Hilmer, 20162525. Nguyen TN, Cumming RG, Hilmer SN. The Impact of Frailty on Mortality, Length of Stay and Re-hospitalisation in Older Patients with Atrial Fibrillation. Heart Lung Circ. 2016;25(6):551-7. Doi: 10.1016/j.hlc.2015.12.002 https://doi.org/10.1016/j.hlc.2015.12.00...
|
Australia |
Clinical |
To investigate the impact of frailty on mortality, hospitalization time and readmission in hospitalized aged patients with arterial fibrillation. |
302 |
Prospective cohort study |
84.7±7.1 |
EFS§§
|
Not reported |
Prevalence of frailty HR‡ 0.53 (0.48 - 0.59) Prevalence of delirium HR‡ 0.10 (0.07 - 0.14) Risk of delirium in frail patients RR§ 1.00 (0.51 - 1.98) |
Assmann, et al., 20162626. Assmann P, Kievit P, van der Wulp K, Verkroost M, Noyez L, Bor H, et al. Frailty is associated with delirium and mortality after transcatheter aortic valve implantation. Open Heart. 2016;3(2):e000478. Doi: 10.1136/openhrt-2016-000478 https://doi.org/10.1136/openhrt-2016-000...
|
Netherlands |
Cardiac surgery (TAVI‡‡) |
To evaluate frailty as an indicator to predict delirium and mortality after TAVI‡‡. |
89 |
Prospective cohort study |
80.4 |
FI|| and Clinical judgment |
DSM-4||||
|
Prevalence of frailty HR‡ 0.53 (0.43 - 0.63) Prevalence of delirium HR‡ 0.28 (0.20 - 0.38) |
Chew, et al., 20172727. Chew J, Lim WS, Chong MS, Ding YY, Tay L. Impact of frailty and residual subsyndromal delirium on 1-year functional recovery: A prospective cohort study. Geriatr Gerontol Int. 2017;17(12):2472-8. Doi: 10.1111/ggi.13108 https://doi.org/10.1111/ggi.13108...
|
Singapore |
Surgical |
To investigate the association between frailty and incomplete recovery from delirium at discharge and to examine the mediating role of incomplete recovery in the relationship between frailty and functional recovery 12 months after delirium.
|
234 |
Prospective cohort study |
84.1±7.1 |
FI|| (20 items) (Frail>0.25) |
DRS-R-98¶¶
|
Prevalence of frailty HR‡ 0.68 (0.62 - 0.74) Prevalence of delirium HR‡ 0.23 (0.18 - 0.28) Risk of delirium in frail patients RR§ 0.90 (0.84 - 0.98) |
Ogawa, et al., 20172828. Ogawa M, Izawa KP, Satomi-Kobayashi S, Tsuboi Y, Komaki K, Gotake Y, et al. Impact of delirium on postoperative frailty and long term cardiovascular events after cardiac surgery. PLoS One. 2017;12(12):e0190359. Doi: 10.1371/journal.pone.0190359 https://doi.org/10.1371/journal.pone.019...
|
Japan |
Cardiac surgery |
To examine the associations between delirium and postoperative frailty and mayor cardiac adverse events. |
326 |
Prospective cohort study |
68.6±14.8 |
Handgrip strength and gait speed |
ICDSC***
|
Prevalence of frailty HR‡ 0.07 (0.04 - 0.10) Prevalence of delirium HR‡ 0.13 (0.10 - 0.17) Risk of delirium in frail patients RR§ 3.16 (1.67 - 5.96) |
Gleason, et al., 20172929. Gleason LJ, Benton EA, Alvarez-Nebreda ML, Weaver MJ, Harris MB, Javedan H. FRAIL Questionnaire Screening Tool and Short-Term Outcomes in Geriatric Fracture Patients. J Am Med Dir Assoc. 2017 Dec 1;18(12):1082-6. Doi: 10.1016/j.jamda.2017.07.005 https://doi.org/10.1016/j.jamda.2017.07....
|
USA |
Orthopedic surgery and Geriatrics service |
To stratify frailty in older adults admitted with fractures to determine its association with the postoperative results. |
175 |
Retrospective cohort study |
82.3±7.4 |
FRAIL |
Not performed |
Prevalence of frailty HR‡ 0.42 (0.35 - 0.49) Prevalence of delirium HR‡ 0.20 (0.15 - 0.27) Risk of delirium in frail patients RR§ 0.48 (0.26 - 0.87) |
Dani, et al., 20181313. Dani M, Owen LH, Jackson TA, Rockwood K, Sampson EL, Davis D. Delirium, Frailty, and Mortality: Interactions in a Prospective Study of Hospitalized Older People. J Gerontol A Biol Sci Med Sci. 2018;73(3):415-8. Doi: 10.1093/gerona/glx214 https://doi.org/10.1093/gerona/glx214...
|
United Kingdom |
Emergency Sector |
To evaluate the impact of delirium on mortality in a cohort evaluated for frailty. |
710 |
Prospective cohort study |
83.1±7.41 |
FI|| (31 items) |
CAM†
|
Prevalence of delirium HR‡ 0.10 (0.08 - 0.13) |
Tanaka, et al., 20183030. Tanaka S, Ueno M, Iida H, Kaibori M, Nomi T, Hirokawa F, et al. Preoperative assessment of frailty predicts age-related events after hepatic resection: a prospective multicenter study. J Hepatobiliary Pancreat Sci. 2018;25(8):377-87. Doi: 10.1002/jhbp.568 https://doi.org/10.1002/jhbp.568...
|
Japan |
Liver resection surgery |
To apply the Kihon Checklist to evaluate preoperative frailty in older adults to predict outcomes after liver resection. |
217 |
Multicenter and prospective cohort study |
75 frail and age 72 non-frail people |
KC††† (Frail≥8) |
ICDSC***
|
Prevalence of frailty HR‡ 0.29 (0.23 - 0.35) Prevalence of delirium HR‡ 0.12 (0.09 - 0.17) Risk of delirium in frail patients RR§ 6.52 (1.79 - 23.78) |
Giroux, et al., 201899. Giroux M, Sirois MJ, Boucher V, Daoust R, Gouin É, Pelletier M, et al. Frailty Assessment to Help Predict Patients at Risk of Delirium When Consulting the Emergency Department. J Emerg Med. 2018;55(2):157-64. Doi: 10.1016/j.jemermed.2018.02.032 https://doi.org/10.1016/j.jemermed.2018....
|
Canada |
Emergency Sector |
To evaluate if frailty screening in older adults in the Emergency Department can help identify the risk of delirium. |
335 |
Prospective cohort study |
76.8±8.1 |
CFS‡‡‡ (Frail>5/7) |
CAM†
|
Prevalence of frailty HR‡ 0.21 (0.17 - 0.26) Prevalence of delirium HR‡ 0.12 (0.09 - 0.16) Risk of delirium in frail patients RR§ 3.79 (2.16 - 6.63) |
Alabaf Sabbaghi, et al., 20183131. Alabaf Sabbaghi S, De Souza D, Sarikonda P, Keevil VL, Wallis SJ, Romero-Ortuno R. Allocating patients to geriatric medicine wards in a tertiary university hospital in England: A service evaluation of the Specialist Advice for the Frail Elderly (SAFE) team. Aging Med (Milton). 2018;1(2):120-4. Doi: 10.1002/agm2.12029 https://doi.org/10.1002/agm2.12029...
|
United Kingdom |
Emergency Sector |
To compare the clinical characteristics, frailty, dementia and delirium in a hospital with a specialized counseling team for frail older adults versus usual treatment. |
6,191 |
Retrospective and documentary |
84.6±6.3 |
CFS‡‡‡
|
4-ATM§§§
|
Prevalence of frailty HR‡ 0.05 (0.04 - 0.06) Prevalence of delirium HR‡ 0.12 (0.11 - 0.13) |
Nomura, et al., 20183232. Nomura Y, Nakano M, Bush B, Tian J, Yamaguchi A, Walston J, et al. Observational Study Examining the Association of Baseline Frailty and Postcardiac Surgery Delirium and Cognitive Change. Anesth Analg. 2019;129(2):507-14. Doi: 10.1213/ANE.0000000000003967 https://doi.org/10.1213/ANE.000000000000...
|
Japan |
Cardiac surgery |
To examine the hypothesis that baseline frailty would be associated with postoperative delirium and to cognitive changes from 1 to 12 months after a cardiac surgery. |
133 |
Prospective cohort study |
Robust 69.3±7.9 Frail 73.4±8.09 |
Fried’s Phenotype |
CAM† and CAM-ICU||||||
|
Prevalence of frailty HR‡ 0.34 (0.26 - 0.42) Prevalence of delirium HR‡ 0.48 (0.40 - 0.56) Risk of delirium in frail patients RR§ 1.04 (0.68 - 1.58) |
Goudzwaard, et al., 20183333. Goudzwaard JA, de Ronde-Tillmans MJAG, El Faquir N, Acar F, Van Mieghem NM, Lenzen MJ, et al. The Erasmus Frailty Score is associated with delirium and 1-year mortality after Transcatheter Aortic Valve Implantation in older patients. The TAVI Care & Cure program. Int J Cardiol. 2019;276:48-52. Doi: 10.1016/j.ijcard.2018.10.093 https://doi.org/10.1016/j.ijcard.2018.10...
|
Netherlands |
Cardiac surgery (TAVI‡‡) |
To investigate the association between a new Erasmus Frailty Score and short- and long-term results after TAVI‡‡. |
213 |
Prospective cohort study |
82.0 (IQR: 78.2 - 85.6) |
Erasmus Frailty Score (>3/5 of the domains) |
Geriatric clinical evaluation |
Prevalence of frailty HR‡ 0.29 (0.23 - 0.35) Prevalence of delirium HR‡ 0.20 (0.15 - 0.26) |
Geriatric Medicine Research Collaborative, 20193434. Geriatric Medicine Research Collaborative. Delirium is prevalent in older hospital inpatients and associated with adverse outcomes: results of a prospective multi-centre study on World Delirium Awareness Day. BMC Med. 2019;17(1):229. Doi: 10.1186/s12916-019-1458-7 https://doi.org/10.1186/s12916-019-1458-...
|
United Kingdom |
Emergency Sector |
To evaluate frailty and the patient’s/hospital’s risk factors for delirium.
|
1507 |
Prospective cohort study |
80.0±8.3 |
CFS‡‡‡
|
4-ATM§§§ and DSM-5¶
|
Prevalence of frailty HR‡ 0.66 (0.64 - 0.68) Prevalence of delirium HR‡ 0.15 (0.13 - 0.17) Risk of delirium in frail patients RR§ 2.83 (2.21 - 3.62) |
Saravana-Bawan, et al., 20193535. Saravana-Bawan B, Warkentin LM, Rucker D, Carr F, Churchill TA, Khadaroo RG. Incidence and predictors of postoperative delirium in the older acute care surgery population: a prospective study. Can J Surg. 2019;62(1):33-8. Doi: 10.1503/cjs.016817 https://doi.org/10.1503/cjs.016817...
|
Canada |
Emergency general surgery |
To evaluate the incidence and risk factors of delirium in older adults subjected to emergency surgeries. |
332 |
Prospective cohort study |
76.1±7.66 |
CFS‡‡‡
|
CAM†
|
Prevalence of frailty HR‡ 0.24 (0.20 - 0.29) Prevalence of delirium HR‡ 0.23 (0.19 - 0.28) Risk of delirium in frail patients RR§ 2.58 (1.76 - 3.79) |
Bellelli, et al., 20191010. Bellelli PG, Biotto M, Morandi A, Meagher D, Cesari M, Mazzola P, et al. The relationship among frailty, delirium and attentional tests to detect delirium: a cohort study. Eur J Intern Med. 2019;70:33-8. Doi: 10.1016/j.ejim.2019.09.008 https://doi.org/10.1016/j.ejim.2019.09.0...
|
Italy |
Acute care (Geriatric emergency) |
To evaluate if frailty is associated with delirium and if it affects performance in three attention tests. |
89 |
Prospective cohort study |
83.15±6.05 |
FI|| (38 items) |
4-ATM§§§ and DSM-5¶
|
Prevalence of frailty HR‡ 0.47 (0.37 - 0.58) Prevalence of delirium HR‡ 0.42 (0.32 - 0.52) Risk of delirium in frail patients RR§ 1.84 (1.10 - 3.09) |
Goudzaard, et al., 20203636. Goudzwaard JA, de Ronde-Tillmans MJAG, de Jager TAJ, Lenzen MJ, Nuis RJ, van Mieghem NM, et al. Incidence, determinants and consequences of delirium in older patients after transcatheter aortic valve implantation. Age Ageing. 2020;49(3):389-94. Doi: 10.1093/ageing/afaa001 https://doi.org/10.1093/ageing/afaa001...
|
Netherlands |
Cardiac surgery (TAVI‡‡) |
To investigate the incidence, the determinants and the consequences of postoperative delirium in aged patients subjected to TAVI‡‡. |
543 |
Prospective cohort study |
79.1±8.0 |
Erasmus Frailty Score (>3/5 of the domains) |
Geriatric clinical evaluation |
Prevalence of frailty HR‡ 0.28 (0.25 - 0.32) Prevalence of delirium HR‡ 0.14 (0.11 - 0.17) Risk of delirium in frail patients RR§ 2.22 (1.44 - 3.42) |
Itagaki, et al., 20203737. Itagaki A, Sakurada K, Matsuhama M, Yajima J, Yamashita T, Kohzuki M. Impact of frailty and mild cognitive impairment on delirium after cardiac surgery in older patients. J Cardiol. 2020;76(2):147-53. Doi: 10.1016/j.jjcc.2020.02.007 https://doi.org/10.1016/j.jjcc.2020.02.0...
|
Japan |
Cardiac surgery |
To examine how physical frailty and cognitive impairment affect the incidence of delirium after cardiac surgeries in older patients. |
89 |
Retrospective study |
74.9±5.5 |
j-CHS¶¶¶
|
ICDSC***
|
Prevalence of frailty HR‡ 0.27 (0.19 - 0.37) Prevalence of delirium HR‡ 0.35 (0.26 - 0.45) Risk of delirium in frail patients RR§ 2.51 (1.24 - 5.08) |
Saljuqi, et al., 20203838. Saljuqi AT, Hanna K, Asmar S, Tang A, Zeeshan M, Gries L, et al. Prospective Evaluation of Delirium in Geriatric Patients Undergoing Emergency General Surgery. J Am Coll Surg. 2020;230(5):758-65. Doi: 10.1016/j.jamcollsurg.2020.01.029 https://doi.org/10.1016/j.jamcollsurg.20...
|
USA |
Emergency general surgery |
To evaluate the impact of frailty on delirium and on other outcomes in geriatric patients subjected to emergency general surgeries. |
163 |
Prospective cohort study |
71±7 |
EGSSFI****
|
CAM†
|
Prevalence of delirium HR‡ 0.26 (0.20 - 0.33) Risk of delirium in frail patients RR§ 2.50 (1.50 - 4.17) |
Susano, et al., 20203939. Susano MJ, Grasfield RH, Friese M, Rosner B, Crosby G, Bader AM, et al. Brief Preoperative Screening for Frailty and Cognitive Impairment Predicts Delirium after Spine Surgery. Anesthesiology. 2020;133(6):1184-91. Doi: 10.1097/ALN.0000000000003523 https://doi.org/10.1097/ALN.000000000000...
|
USA |
Orthopedic surgery (spine) |
To test the hypothesis that preoperative screening for frailty or cognitive impairment identifies patients at risk for postoperative delirium (primary endpoint). |
229 |
Prospective cohort study |
≥70 to 75 |
FRAIL |
CAM†
|
Prevalence of frailty HR‡ 0.24 (0.19 - 0.30) Prevalence of delirium RR§ 0.25 (0.20 - 0.31) |
Mahanna-Gabrielli, et al., 20204040. Mahanna-Gabrielli E, Zhang K, Sieber FE, Lin HM, Liu X, Sewell M, et al. Frailty Is Associated with Postoperative Delirium but Not With Postoperative Cognitive Decline in Older Noncardiac Surgery Patients. Anesth Analg. 2020;130(6):1516-23. Doi: 10.1213/ANE.0000000000004773 https://doi.org/10.1213/ANE.000000000000...
|
USA |
Major non-cardiac surgery |
To examine the relationship between frailty and postoperative delírium after a large-size non-cardiac surgery. |
167 |
Prospective cohort study |
70 |
FRAIL |
CAM-ICU||||||
|
Prevalence of frailty HR‡ 0.19 (0.13 - 0.25) Prevalence of delirium HR‡ 0.25 (0.19 - 0.32) Risk of delirium in frail patients RR§ 1.78 (1.01 - 3.13) |
Chen; Qin, 20214141. Chen Y, Qin J. Modified Frailty Index Independently Predicts Postoperative Delirium and Delayed Neurocognitive Recovery After Elective Total Joint Arthroplasty. J Arthroplasty. 2021;36(2):449-53. Doi: 10.1016/j.arth.2020.07.074 https://doi.org/10.1016/j.arth.2020.07.0...
|
China |
Orthopedic surgery |
To examine the discriminatory value of the Frailty Index to predict postoperative delirium and cognitive dysfunction after total hip arthroplasty. |
383 |
Prospective cohort study |
72 (from 65 to 85) |
FI|| (11 items) Frail>0.18) |
DSM-5¶
|
Prevalence of frailty HR‡ 0.54 (0.49 - 0.59) Prevalence of delirium HR‡ 0.17 (0.14 - 0.21) Risk of delirium in frail patients RR§ 1.70 (1.06 - 2.72) |