Evidence map›Paper›PMID 32921993›Full record

ArticleClinical interventions in aging2020

Physical Performance and Risk of Postoperative Delirium in Older Adults Undergoing Aortic Valve Replacement.

Aarti Rao, Sandra M Shi, Jonathan Afilalo, Jeffrey J Popma, Kamal R Khabbaz, Roger J Laham, Kimberly Guibone, Edward R Marcantonio, Dae Hyun Kim

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical interventions in aging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
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  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Aarti RaoIcahn School of Medicine at Mount Sinai, New York, NY, USA.ORCID 0000-0002-6167-5429
Sandra M ShiDivision of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.ORCID 0000-0001-6801-5602
Jonathan AfilaloDivision of Cardiology and Centre for Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.ORCID 0000-0003-0555-4937
Jeffrey J PopmaDivision of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Kamal R KhabbazDivision of Cardiac Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Roger J LahamDivision of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Kimberly GuiboneDivision of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Edward R Marcantonio *Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.ORCID 0000-0002-2911-4250
Dae Hyun Kim *Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.ORCID 0000-0001-7290-6838
Beth Israel Deaconess Medical Center · USIcahn School of Medicine at Mount Sinai · USJewish General Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelirium is a major risk factor for poor recovery after surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR). It is unclear whether preoperative physical performance tests improve delirium prediction.

objectiveTo examine whether physical performance tests can predict delirium after SAVR and TAVR, and adapt an existing delirium prediction rule for cardiac surgery, which includes Mini-Mental State Examination (MMSE), depression, prior stroke, and albumin level.

designProspective cohort, 2014-2017.

settingSingle academic center. SUBJECTS: A total of 187 patients undergoing SAVR (n=77) or TAVR (n=110).

methodsThe Short Physical Performance Battery (SPPB) score was calculated based on gait speed, balance, and chair stands (range: 0-12 points, lower scores indicate poor performance). Delirium was assessed using the Confusion Assessment Method. We fitted logistic regression to predict delirium using SPPB components and risk factors of delirium.

resultsDelirium occurred in 35.8% (50.7% in SAVR and 25.5% in TAVR). The risk of delirium increased for lower SPPB scores: 10-12 (28.2%), 7-9 (34.5%), 4-6 (37.5%) and 0-3 (44.1%) (p-for-trend=0.001). A model that included gait speed <0.46 meter/second (OR, 2.7; 95% CI, 1.2-6.4), chair stands time ≥11.2 seconds (OR, 3.5; 95% CI, 1.0-12.4), MMSE <24 points (OR, 2.9; 95% CI, 1.3-6.4), isolated SAVR (OR, 5.4; 95% CI, 2.1-13.8), and SAVR and coronary artery bypass grafting (OR, 15.8; 95% CI, 5.5-45.7) predicted delirium better than the existing prediction rule (C statistics: 0.71 vs 0.61; p=0.035).

conclusionAssessing physical performance, in addition to cognitive function, can help identify high-risk patients for delirium after SAVR and TAVR.

Indexed as

Physical Functional PerformanceAgedAged, 80 and overAortic ValveCohort StudiesDeliriumFemaleHeart Valve ProsthesisHumansLogistic ModelsMaleProspective StudiesRisk FactorsTranscatheter Aortic Valve ReplacementTreatment Outcomeaortic valve replacementdeliriumphysical performanceprediction

Identifiers

PMID32921993
PMCPMC7455771
OpenAlexW3080915751

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.