ArticleJournal of the American College of Surgeons2017
Cognitive Impairment and Overall Survival in Frail Surgical Patients.
Article in Journal of the American College of Surgeons, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 27 citations in OpenAlex.
- Frailty and body composition predict adverse outcomes after emergency general surgery admission: a multicentre observational cohort study.Annals of the Royal College of Surgeons of England · 2025Observational
- Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery.Annals of geriatric medicine and research · 2025Article
- The potential mechanism of mitochondrial homeostasis in postoperative neurocognitive disorders: an in-depth review.Annals of medicine · 2024Review
- Low free testosterone is associated with increased mortality in frail surgical patients.Surgery open science · 2022Article
- Physical and Cognitive Function Assessment to Predict Postoperative Outcomes of Abdominal Surgery.The Journal of surgical research · 2021Article
- Review
- Cognitive Frailty and 30-Day Mortality in a National Cohort of Older Chinese Inpatients.Clinical interventions in aging · 2021Article
- Abnormal preoperative cognitive screening in aged surgical patients: a retrospective cohort analysis.British journal of anaesthesia · 2021Observational
- Brief Preoperative Screening for Frailty and Cognitive Impairment Predicts Delirium after Spine Surgery.Anesthesiology · 2020Article
- A Preoperative Cognitive Screening Test Predicts Increased Length of Stay in a Frail Population: A Retrospective Case-Control Study.Anesthesia and analgesia · 2019Article
- SIRT3 activator honokiol ameliorates surgery/anesthesia-induced cognitive decline in mice through anti-oxidative stress and anti-inflammatory in hippocampus.CNS neuroscience & therapeutics · 2019Article
- Honokiol-Mediated Mitophagy Ameliorates Postoperative Cognitive Impairment Induced by Surgery/Sevoflurane via Inhibiting the Activation of NLRP3 Inflammasome in the Hippocampus.Oxidative medicine and cellular longevity · 2019Article
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11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe definition of frailty, as modeled by the Fried criteria, has been limited primarily to the physical domain. The purpose of this study was to assess the additive value of cognitive function with existing frailty criteria to predict poor postoperative outcomes in a large multidisciplinary cohort of patients undergoing major operations. STUDY
designA 4-level composite frailty scoring system was created via the combination of the Fried frailty score and the Emory Clock Draw Test to assess preoperative frailty and cognitive impairment, respectively. Overall survival was defined as months from date of operation to date of death or last follow-up.
resultsThis study included 330 patients undergoing major operations; mean age was 58 years and a total of 53 patient deaths occurred during 4-year follow-up. Among the robust cohort, 20 of 168 patients died (11.9%), and among those who were both physically frail and cognitively impaired, 11 of 26 patients died (42.3%). Multivariable analysis demonstrated the physically frail and cognitively impaired cohort to have a 3.92 higher risk of death (95% CI 1.66 to 9.26) compared with the cohort of robust patients (p = 0.002). Kaplan-Meier survival curves reveal an overall difference in long-term survival (log-rank p < 0.0001), driven mainly by the high risk of mortality among patients with both physical frailty and cognitive impairment.
conclusionsThe use of a combined frailty and cognitive assessment score has a more powerful potential to predict adult patients at higher risk of overall survival than either measurement alone. The addition of cognitive assessment to physical frailty measure can lead to improved preoperative decision making and possibly early intervention, as well as more accurate patient counseling.
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