Correlation of preoperative frailty with postoperative delirium and one-year mortality in Chinese geriatric patients undergoing noncardiac surgery: Study protocol for a prospective observational cohort study

Min Zhang; Xiaojun Gao; Mengjie Liu; Zhongquan Gao; Xiaxuan Sun; Linlin Huang; Ting Zou; Yongle Guo; Lina Chen; Yang Liu; Xiaoning Zhang; Hai Feng; Yuelan Wang; Yongtao Sun

doi:10.1371/journal.pone.0295500

Correlation of preoperative frailty with postoperative delirium and one-year mortality in Chinese geriatric patients undergoing noncardiac surgery: Study protocol for a prospective observational cohort study

PLoS One. 2024 Mar 6;19(3):e0295500. doi: 10.1371/journal.pone.0295500. eCollection 2024.

Authors

Min Zhang¹, Xiaojun Gao¹, Mengjie Liu¹, Zhongquan Gao^{1

2}, Xiaxuan Sun^{1

2}, Linlin Huang³, Ting Zou³, Yongle Guo^{1

2}, Lina Chen¹, Yang Liu¹, Xiaoning Zhang¹, Hai Feng¹, Yuelan Wang⁴, Yongtao Sun¹

Affiliations

¹ Department of Anesthesiology, Shandong Institute of Anesthesia and Respiratory Critical Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
² Department of Anesthesiology, Shandong First Medical University, Jinan, China.
³ Department of Nursing, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
⁴ Department of Anesthesiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital), Jinan, China.

Abstract

Background: To Frailty is associated with postoperative delirium (POD) but is rarely assessed in patients undergoing noncardiac surgery. In this study, the correlation between preoperative frailty and POD, one-year mortality will be investigated in noncardiac Chinese geriatric surgery patients.

Methods: This study is a prospective, observational, cohort study conducted at a single center with Chinese geriatric patients. Patients who undergo noncardiac surgery and are older than 70 years will be included. A total of 536 noncardiac surgery patients will be recruited from the First Affiliated Hospital of Shandong First Medical University for this study. The Barthel Index (BI) rating will be used to assess the patient's ability to carry out everyday activities on the 1st preoperative day. The modified frailty index (mFI) will be used to assess frailty. Patients in the nonfrailty group will have an mFI < 0.21, and patients in the frailty group will have an mFI ≥ 0.21. The primary outcome is the incidence of POD. Three-Minute Diagnostic Interview for CAM-defined Delirium (3D-CAM) will be conducted twice daily during the 1st-7th postoperative days, or just before discharge. The secondary outcomes will include one-year mortality, in-hospital cardiopulmonary events, infections, acute renal injury, and cerebrovascular events.

Discussion: This study will clarify the correlation of preoperative frailty with POD and one-year all-cause mortality in Chinese geriatric patients undergoing noncardiac surgery. Can preoperative frailty predict POD or one-year mortality? In the face of China's serious aging social problems, this result may have important clinical value for the surgical treatment of geriatric patients.

Trial registration: This protocol has been registered with ClinicalTrials. Gov on 12 January 2022 (https://clinicaltrials.gov/ct2/show/NCT05189678).

Copyright: © 2024 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Clinical Trial Protocol

MeSH terms

Aged
China / epidemiology
Cohort Studies
Emergence Delirium*
Frailty* / complications
Humans
Observational Studies as Topic
Prospective Studies

Associated data

ClinicalTrials.gov/NCT05189678

Grants and funding

1. Project 2019QL015 supported by the Academic Promotion Programme of Shandong First Medical University. YW, YS, ML, Shandong First Medical University, financial support 20 million RMB, https://www.sdfmu.edu.cn/ . 2. Project 202019170 supported by the Jinan Science and Technology Plan (Clinical Medicine Science and Technology Innovation Plan). YS, MZ, QG, JG, Jinan Science and Technology Bureau, financial support 100 thousand RMB, http://jnsti.jinan.gov.cn/ . 3. Project ZR2022MH221 supported by the Shandong Provincial Natural Science Foundation. YS, MZ, ML, XG, ZG, YG, Natural Science Foundation of Shandong Province, financial support 100 thousand RMB, http://cloud.kjt.shandong.gov.cn/ . The funders had and will not have a role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.