Association of preoperative cognitive frailty with postoperative complications in older patients under general anesthesia: a prospective cohort study

作者：Jiamin Fang, Hao Liang, Muxin Chen, Yidi Zhao, Lin Wei · 发表于：BMC Geriatrics · 年份：2024 · DOI：10.1186/s12877-024-05431-1 · 被引用次数：16 · 研究领域：Frailty in Older Adults、Intensive Care Unit Cognitive Disorders、Cardiac, Anesthesia and Surgical Outcomes

BACKGROUND: Cognitive frailty (CF) is characterized by the coexistence of physical frailty and cognitive impairment, and it is associated with adverse health outcomes. Older adults are particularly vulnerable to CF due to factors such as age-related brain changes and the presence of comorbidities. OBJECTIVE: To investigate the effect of preoperative CF on postoperative complications in older patients. METHODS: This prospective cohort study was conducted among 253 patients aged 60-85 years, who underwent elective orthopedic and abdominal surgery (with a postoperative hospital stay of ≥ 3 days) at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2023 to November 2023. CF was assessed using the Montreal Cognitive Assessment (MoCA) for the cognitive status and the Fried criteria for five frailty scales. Participants were split into four groups: Group A (neither frailty nor cognitive impairment), Group B (frailty without cognitive impairment), Group C (cognitive impairment without frailty), and Group D (cognitive frailty). The primary outcome was postoperative complications, while secondary outcomes included mobility disability, prolonged hospital stay (PLOS), re-operation and 90-day readmission. RESULTS: The median age (interquartile range) of participants was 69 (65-73) years, of which 40.3% were male. The prevalence of CF was 17.8%. The incidence of postoperative complications was 18.2% in Group A, 50.0% in Group B, 37.4% in Group C, and 75.6%...