Table 1.
Characteristics of Studies Selected for Qualitative Review and Meta-Analysis
| Study (Year) | Patients, N | Frailty Metric | Score Indicating Frailty | Percent Frail | Percent Prefrail | Postoperative Delirium Metric | Percent Delirium | Adjusted Odds Ratio (95% CI) | Variables Adjusted For |
|---|---|---|---|---|---|---|---|---|---|
| Eide et al22 (2015) | 136 | SOF | 0 = nonfrail, 1 = prefrail, 2–3 = frail |
39 | 27.3 | CAM | 55.9 | 0.8 (0.4–1.8) P = 0.059 |
Sex, ADL, A-fib, CCI, MMSE, Post-op opioids, post-op anxiolytics, TAVI |
| Itagaki et al29 (2020) | 89 | J-CHS (Fried) | 0 = nonfrail, 1–2 = prefrail, 3–5 = frail |
38.2 | - | ICDSC | 28.1 | 4.5 (1.7–12.4) P = 0.003 |
MoCA, sex, age, albumin, operation |
| Jung et al25 (2015) | 133 | Modified Fried | >2 = frail | 54.1 | - | CAM, CAM-ICU | 18.0 | 5.1 (1.6–16.1) P = .0015 |
EUROSCORE II |
| Khan et al30 (2016) | 25 | Modified Fried | >2 = frail | 56.0 | - | CAM-ICU | 8.0 | 0.77 (0.04–13.87)a | Unadjusted* |
| Leung et al26 (2011) | 63 | Fried | 0 = nonfrail, 1–2 = prefrail, 3–5 = frail |
33.3 | 50.8 | CAM | 25.4 | 1.8 (1.1–3.2)b P = 0.028 |
Age, ADL, IADL, TICS, GDS |
| Mahanna-Gabrielli et al28 (2020) | 167 | FRAIL scale | 0 = nonfrail, 1–2 = prefrail, 3–5 = frail |
18.6 | 43.1 | CAM-ICU | 22.8 | 2.7 97.5% (1.0–7.3)c | Age, sex, education, surgical duration, surgical type, ASA status, baseline cognition |
| Nomura et al27 (2019) | 128 | Fried | 0 = nonfrail, 1–2 = prefrail, 3–5 = frail |
31.3 | 57 | CAM-ICU | 43.8 | 6.3 (1.2–33.7) P = 0.31 |
Age, sex, education, LESCORE |
| Partridge et al24 (2015) | 125 | EFS | >6.5 = frail | 52 | - | CAM | 19.2 | 1.7 (0.7–4.2)d | Univariate analysis only |
| Pol et al23 (2011) | 142 | GFI | >3 = frail | 35.2 | - | DOS | 7.0 | 1.9 (0.9–3.7) P = 0.05e |
CRP, CCI, GFI, impaired renal function |
Abbreviations: ADL, activities of daily living; A-fib, atrial fibrillation; ASA, American Society of Anesthesiologists; CAM, Confusion Assessment Method; CAM-ICU, Confusion Assessment Method for the intensive care unit; CCI, Charlson comorbidity index; CRP, C-reactive protein; DOS, Delirium Observation Scale; EFS, Edmonton Frail Scale; GDS, geriatric depression scale; GFI, Groningen Frailty Indicator; IADL, instrumental activities of daily living; ICDSC, Intensive Care Delirium Screening Checklist; J-CHS, Japanese version of the cardiovascular health study; MMSE, Mini-Mental-State Examination; LESCORE, Logistic European System for Cardiac Operative Risk Evaluation; SOF, Study of Osteoporotic Fractures; TAVI, Transcatheter Aortic Valve Implantation; TICS, Telephone Interview for Cognitive Status.
9.1% nonfrail, 6.2% frail, no p value reported. Based on our own calculation form data abstraction, unadjusted values.
Values given are for preoperative frailty score, not category.
No adjusted P value.
Based on our own calculation, abstracted from raw data. Unadjusted values.
Odds ratio is for GFI score, not frailty