ArticleCureus2025
Association of Postoperative Delirium and Perioperative Factors With Frailty in Laparoscopic Gastrointestinal Surgery: A Retrospective Observational Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundIn the current era of advancing population aging, perioperative management of elderly patients has become a crucial challenge. Frailty is recognized as a condition associated with poor postoperative outcomes, and, particularly, postoperative delirium is an urgent issue for healthcare settings as a major complication in elderly patients. Currently, there is no established international standard for assessing frailty; thus, further understanding in this field is required.
objectiveThis study aimed to elucidate the association between preoperative frailty and the incidence of postoperative delirium and pain in patients undergoing gastrointestinal laparoscopic surgery.
methodsPatients aged 70 years and older who underwent gastrointestinal laparoscopic surgery between July 2019 and May 2022 were assessed using the clinical frailty scale (CFS). Based on the CFS score, participants were categorized into two groups: non-frail (CFS≤3) and frail (CFS≥4). Statistical analyses were conducted to compare outcomes between the groups.
resultsA total of 323 cases were analyzed, comprising 228 patients in the non-frail group and 95 in the frail group. Logistic regression analysis was performed for variables that showed significant differences. In univariate analysis, significant differences were found in six items: age, length of hospital stay, ASA Physical Status Classification (ASA-PS), presence of physical restraint, postoperative delirium screening tool (DST), and postoperative pain. Multivariate analysis confirmed that all six variables remained significantly associated.
conclusionAmong frail patients undergoing gastrointestinal laparoscopic surgery, key perioperative factors associated with frailty included advanced age, prolonged hospitalization, higher ASA-PS scores, use of physical restraints, increased DST positivity rates postoperatively, and greater postoperative pain. Each of these factors is a potential contributor to delirium, suggesting that frail individuals are at heightened risk of developing delirium due to these associated variables.
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