Evidence map›Paper›PMID 39499033›Full record

ArticleJournal of the American Geriatrics Society2025

Delirium risk profiles in a population-based study of United States older adults undergoing common noncardiac surgeries.

Hyundeok Joo, Thiago J Avelino-Silva, L Grisell Diaz-Ramirez, Sei J Lee, Elizabeth L Whitlock

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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

5 authors.

Hyundeok JooDepartment of Anesthesia & Perioperative Care, University of California, San Francisco, California, USA.ORCID 0000-0002-6134-8815
Thiago J Avelino-SilvaDivision of Geriatrics, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA.ORCID 0000-0001-9347-0519
L Grisell Diaz-RamirezDivision of Geriatrics, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA.
Sei J LeeDivision of Geriatrics, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA.
Elizabeth L WhitlockDepartment of Anesthesia & Perioperative Care, University of California, San Francisco, California, USA.ORCID 0000-0002-6868-4301

Funding

HRS Yrs29-34: Y33 SSA CoFundingU01AG009740 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Faul, KENNETH M LANGA · 1990 to 2026
$555.8M
Integrting Information About Aging SurveysR01AG030153 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Sara Adar, Alden L. Gross · 2007 to 2026
$41.7M
VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Louise C. Walter · 2013 to 2026
$19.9M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Predicting long-term cognitive outcomes and Alzheimer’s disease and related dementias after major noncardiac surgery for older adultsR01AG079263 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Elizabeth Louisa Whitlock · 2022 to 2026
$3.3M
Mega Meta Data Set of the Health and Retirement Surveys Around the WorldRC2AG036619 · NIA · RAND CORPORATION · PI KAPTEYN, ARIE · 2009 to 2010
$2.0M
Mentoring Patient-Oriented Research to Individualize Care for Hospitalized Older Adults with and without Alzheimer's Disease and Related DementiasK24AG066998 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Sei Lee · 2021 to 2026
$1.1M
Archiving & Creating User Friendly Data: the Longitudinal Aging Survey in IndiaR03AG043052 · NIA · RAND CORPORATION · PI LEE, JINKOOK · 2012 to 2012
$95k
NIA NIH HHS K24 AG066998NIA NIH HHS K24AG066998NIA NIH HHS P30 AG044281NIA NIH HHS P30AG044281NIA NIH HHS R01 AG030153NIA NIH HHS R01 AG079263NIA NIH HHS R01AG079263NIA NIH HHS R03 AG043052NIA NIH HHS RC2 AG036619NIA NIH HHS T32 AG000212NIA NIH HHS U01 AG009740NIA NIH HHS U01AG009740
6 · The paper itself

Abstract

backgroundOlder adults often require surgical care and are at elevated risk of delirium. We explored delirium risk profiles across the population of U.S. older adults who underwent one of 10 common noncardiac surgeries.

methodsWe analyzed Health and Retirement Study (HRS) participants linked with Medicare billing data who underwent the following 10 noncardiac surgeries from 2000 to 2018 at age 65 or more: total knee arthroplasty (TKA), total hip arthroplasty (THA), spine surgery, cholecystectomy, colorectal surgery, hernia repair (ventral, umbilical, or incisional), endarterectomy, prostatectomy, transurethral resection of the prostate (TURP), and hysterectomy. Demographic and health covariates were obtained from the HRS dataset. Latent cognitive ability was calculated from cognitive testing, proxy reports, and demographics at the preoperative HRS interview. We compared standardized differences for delirium risk factors across the 10 surgeries and qualitatively clustered them into phenotypical subgroups.

resultsWe analyzed 7424 older adults (mean age 76 ± 6 years, 45% male). Endarterectomy patients presented with the highest burden of nearly all health and cognitive factors, implying higher delirium risk (e.g., stroke, 22%; depressive symptoms, 30%; high school or less education, 73%; frailty, 42%; lowest latent cognitive ability). A second "general surgery" phenotype, including cholecystectomy, colorectal, and hernia surgery patients, experienced more frailty (29%-32%) and depressive symptoms (24%-26%), with moderate comorbidity burden. A third "pain" phenotype, which included TKA, THA, and spine surgery patients, commonly reported moderate or severe pain (47%-53%) and impairment in activities of daily living (ADL, 23%-30%), but fewer comorbid medical conditions. The remaining surgery types (hysterectomy, prostatectomy, TURP) were not phenotypically grouped and generally had lower risk features for delirium.

conclusionIn an epidemiological cohort of US older adults, we identified clinically meaningful heterogeneity in delirium risk profiles across different surgical types, which may have implications for delirium risk stratification and delirium prevention or treatment.

Indexed as

DeliriumPostoperative ComplicationsSurgical Procedures, OperativeAgedAged, 80 and overFemaleHumansMaleMedicareRisk AssessmentRisk FactorsUnited Statesand noncardiac surgeriesolder adultspostoperative deliriumrisk profile

Identifiers

PMID39499033
PMCPMC11907757

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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.