ArticleWorld journal of surgery2018
Clock-Drawing Test as a Bedside Assessment of Post-operative Delirium Risk in Elderly Patients with Accidental Hip Fracture.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 3 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- The Association Between Visual Impairment and Delirium: A Systematic Review and Meta-Analysis.Journal of general internal medicine · 2026Pooled it
- Perioperative Factors Associated With Postoperative Delirium in Patients Undergoing Noncardiac Surgery: An Individual Patient Data Meta-Analysis.JAMA network open · 2023Pooled it
- Development and validation of an international preoperative risk assessment model for postoperative delirium.Age and ageing · 2023Pooled it
- Predicting Postoperative Delirium in Older Patients Before Elective Surgery: Multicenter Retrospective Cohort Study.JMIR aging · 2025Article
- Poor preoperative performance at Clock Drawing Test is associated with postoperative decline in olfaction in older patients: an observational pilot study.BMC anesthesiology · 2023Observational
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrently applied cognitive tests for assessing the risk of post-operative delirium require time and specialised medical staff, in addition to the patients' mental strain. We investigated the four-point scoring Clock-Drawing Test (CDT-4) as a preoperative independent predictor for post-operative delirium.
methodsA total of 100 consecutive patients aged over 65 years admitted for accidental hip fracture were assessed for delirium using the Confusion Assessment Method Scale. The cognitive function was rated with mini-mental state examination, Montreal Cognitive Assessment Scale (MoCA), and CDT-4. Descriptive statistics were performed, and a logistic regression model for post-operative delirium was applied.
resultsOut of the 100 enrolled patients 98 underwent hip repair surgery and 65 (66%) had post-operative delirium, with 24 (42%) incident cases. The median (IQR) ages were 78 (72-83) and 84 (80-87) years for the non-delirium and post-operative delirium groups, respectively. The logistic regression concluded with age and CDT-4 as independent preoperative predictors, while controlling for gender, pre-surgery delirium, MoCA visual, and MoCA attention: OR 1.32 [95% CI (1.099-1.585); p = 0.003] for age; OR 0.153 [95% CI (0.033-0.719); p = 0.017] for CDT-4.
conclusionsEmploying CDT-4 as a bedside assessment of delirium risk may help to preoperatively stratify and prioritise the patients for preventive perioperative care in a timely manner.
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