Observational studyJournal of the American Geriatrics Society2023
A novel approach for the detection of cognitive impairment and delirium risk in older patients undergoing spine surgery.
Observational study in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
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.
Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Perioperative neurocognitive disorders in older patients: a narrative review of current knowledge in 2026.Perioperative medicine (London, England) · 2026Review
- Remote Cognitive Testing for Detection of Baseline Cognitive Impairment and Prediction of Postoperative Delirium Risk: A Pilot Study.Anesthesia and analgesia · 2026Article
- Costs associated with delirium among older patients undergoing complex spine surgeries.Journal of neurosurgery. Spine · 2026Observational
- A comparison of large language model-generated and published perioperative neurocognitive disorder recommendations: a cross-sectional web-based analysis.British journal of anaesthesia · 2026Article
- Association of propofol vs. sevoflurane maintenance anesthesia with postoperative delirium, cognitive decline, and mortality in older adults: a global comparative-effectiveness study.Critical care (London, England) · 2026Article
- A systematic review and meta-analysis on ketamine use and postoperative delirium in older patients undergoing spine or orthopedic surgery.Anesthesiology and perioperative science · 2026Review
- Determining the ground truth for the prediction of delirium in adult patients in acute care: a scoping review.JAMIA open · 2025Review
- Emerging biomarkers of postoperative delirium at the intersection of neuroinflammation and neurodegeneration.Frontiers in aging neuroscience · 2025Review
- Gaps in cognitive care among older patients undergoing spine surgery.Journal of the American Geriatrics Society · 2024Observational
- Impact of Depression on Postoperative Medical and Surgical Outcomes in Spine Surgeries: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Peripheral inflammation and neurocognitive impairment: correlations, underlying mechanisms, and therapeutic implications.Frontiers in aging neuroscience · 2023Review
- Defining the role of Interleukin-6 for the development of perioperative neurocognitive disorders: Evidence from clinical and preclinical studies.Frontiers in aging neuroscience · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPostoperative delirium is a common postsurgical complication in older patients and is associated with high morbidity and mortality. The objective of this study was to determine whether a digital cognitive assessment and patient characteristics could identify those at-risk.
methodsPatients 65 years and older undergoing spine surgeries ≥3 h were evaluated as part of a single-center prospective observational cohort study at an academic medical center, from January 1, 2019, to December 31, 2020. Of 220 eligible patients, 161 were enrolled and 152 completed the study. The primary outcome of postoperative delirium was measured by the Confusion Assessment Method for the Intensive Care Unit or the Nursing Delirium Screening Scale, administered by trained nursing staff independent from the study protocol. Baseline cognitive impairment was identified using the tablet-based TabCAT Brain Health Assessment.
resultsOf the 152 patients included in this study, 46% were women. The mean [SD] age was 72 [5.4] years. Baseline cognitive impairment was identified in 38% of participants, and 26% had postoperative delirium. In multivariable analysis, impaired Brain Health Assessment Cognitive Score (OR 2.45; 95% CI, 1.05-5.67; p = 0.037), depression (OR 4.54; 95% CI, 1.73-11.89; p = 0.002), and higher surgical complexity Tier 4 (OR 5.88; 95% CI, 1.55-22.26; p = 0.009) were associated with postoperative delirium. The multivariate model was 72% accurate for predicting postoperative delirium, compared to 45% for the electronic medical record-based risk stratification model currently in use.
conclusionIn this prospective cohort study of spine surgery patients, age, cognitive impairment, depression, and surgical complexity identified patients at high risk for postoperative delirium. Integration of scalable digital assessments into preoperative workflows could identify high-risk patients, automate decision support for timely interventions that can improve patient outcomes and lower hospital costs, and provide a baseline cognitive assessment to monitor for postoperative cognitive change.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.