Preoperative frailty linked to poorer surgery outcomes in brain tumor resection: Study

Preoperative frailty is associated with poor outcomes in major surgery. Postoperative delirium is common after neurosurgery. To date, the association of preoperative frailty with postoperative delirium after neurosurgery has not been established. Researchers aimed to determine the association between preoperative frailty and postoperative delirium in patients undergoing elective brain tumor resection.

For the study design, the team retrospectively analyzed the data of a prospective cohort, consecutively enrolling adult patients admitted to the intensive care unit after elective craniotomy for brain tumor resection under general anesthesia in a tertiary hospital in China from March 1, 2017 to February 2, 2018. Preoperative frailty was evaluated using the modified frailty index. The primary outcome was postoperative delirium, assessed using the Confusion Assessment Method for the Intensive Care Unit.

Results highlighted some key facts.

• 659 patients met inclusion criteria for our analysis. There were 398 (60.4%) non-frail (modified frailty index = 0), 237 (36.0%) pre-frail (modified frailty index = 1–2), and 24 (3.6%) frail (modified frailty index ≥ 3) patients.
• Of these, 124 (18.8%) developed postoperative delirium. In adjusted analyses, frailty was independently associated with postoperative delirium (odds ratio 1.7, 95% confidence interval 1.0–2.7, P = .032).
• Frail patients had longer length of hospital stay and higher total costs than non-frail patients.
• Adjusted analyses showed an independent connection of frailty with postoperative delirium.
• Longer length of hospital stay and higher total costs were noted in frail patients vs non-frail patients.

" Overall, findings demonstrated a relationship of preoperative frailty with postoperative delirium, length of hospital stay, as well as with total expenses in patients receiving elective brain tumor resection. Preoperative frailty evaluation as well as suitable management approaches are recommended to be included in the perioperative management of postoperative delirium."the team opined.

For full article follow the link: https://doi.org/10.1016/j.surg.2021.05.048

Source : Surgery