Associations of Postoperative Delirium With Perioperative Frailty Worsening and Their Combined Effect on 1-Year Mortality in Older Surgical Patients

Associations of Postoperative Delirium With Perioperative Frailty Worsening and Their Combined Effect on 1-Year Mortality in Older Surgical Patients: A Prospective Cohort Study

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07259850

Enrollment

6196

Registered

2025-12-02

Start date

2020-04-01

Completion date

2023-04-30

Last updated

2025-12-09

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Frailty at Older Adults, Mortality, Postoperative Delirium (POD), Recovery of Function

Keywords

postoperative delirium, frailty, older adults, one year mortality, frailty worsening

Brief summary

Postoperative delirium (POD) is a frequent complication in older surgical patients and is associated with adverse outcomes, while frailty is also highly prevalent during the perioperative period. This study aimed to determine whether POD accelerates perioperative frailty worsening and to assess the effect of their coexistence on 1-year mortality.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

65 Years to No maximum

Healthy volunteers

Inclusion criteria

1. Aged ≥65 years; 2. Scheduled for elective non-cardiac, non-neurosurgical procedures; 3. Consented to undergo preoperative health and functional state assessments.

Exclusion criteria

1. Had severe dementia, language disorders, significant hearing or visual impairments, or were in a coma; 2. Had Mini-Mental State Examination (MMSE) scores below the established educational thresholds: \<18 for illiterate individuals, \<21 for those with primary education (≤6 years), and \<25 for those with secondary education or higher (\>6 years) 3. Underwent local anesthesia or monitored anesthesia care; 4. Had an operative time ≤30 minutes; 5. Incomplete preoperative FRAIL scale assessment; 6. Missing postoperative delirium data; 7. Incomplete FRAIL scale assessment at 1 month postoperatively.

Design outcomes

Primary

Measure	Time frame	Description
The primary outcome was worsened frailty at one month after surgery.	At one month after surgery.	Frailty was assessed preoperatively by trained researchers using the FRAIL scale, which includes five items: fatigue, resistance, ambulation, illnesses, and weight loss. Each item scores 0 or 1, for a total of 0-5 points, with higher scores indicating greater frailty. Patients were categorized as robust (0), pre-frail (1-2), or frail (3-5). A follow-up frailty assessment was conducted one month postoperatively via telephone. Frailty change was defined as the difference between postoperative and preoperative scores: ≤0 indicated stable/improved frailty, and \>0 indicated worsened frailty.

Secondary

Measure	Time frame	Description
The secondary outcome was 1-year all-cause mortality.	At one year after surgery.	A structured telephone follow-up was conducted one year after surgery to determine outcomes.

Countries

China

Outcome results