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. 2024 Nov 27;24(1):971.
doi: 10.1186/s12877-024-05566-1.

Risk of sarcopenia, frailty and malnutrition as predictors of postoperative delirium in surgery

Henriette Louise Moellmann  1 , Eman Alhammadi  2 , Soufian Boulghoudan  3 , Julian Kuhlmann  3 , Anica Mevissen  3 , Philipp Olbrich  3 , Louisa Rahm  3 , Helmut Frohnhofen  4
Affiliations

Risk of sarcopenia, frailty and malnutrition as predictors of postoperative delirium in surgery

Henriette Louise Moellmann et al. BMC Geriatr. .

Abstract

Background: The risk factors for postoperative delirium are numerous and complex. One approach to identifying patients at risk is to evaluate their nutritional status. The aim of this prospective study is to better understand nutrition as a potential risk factor for postoperative delirium.

Methods: A comprehensive preoperative assessment (Clinical Frailty Scale (CFS), the SARC-F questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF)) were carried out as a prospective clinical study on 421 patients (70+) from 4 different surgical disciplines. Postoperatively, patients are examined daily for the presence of delirium using the 4AT screening tool (Arousal, Attention, Abbreviated Mental Test - 4, Acute change), the Nursing Delirium Screening Scale (NuDesc) and the Confusion Assessment Method (CAM) with its adaptation for the intensive care unit (CAM-ICU).

Results: If there were indications of frailty or sarcopenia in the CFS or SARC-F, the association with delirium was increased 5.34-fold (OR of 5.34 [95% CI: 2.57;11.1]) and 5.56-fold (OR of 5.56 [95% CI: 2.97;10.4]) respectively. Delirium also occurred significantly more frequently with the risk of malnutrition or manifest malnutrition (MNA-SF) than with a normal nutritional status.

Conclusions: Patients' preoperative and nutritional status significantly impact the risk of developing postoperative delirium. Factors such as frailty, sarcopenia and possible malnutrition must be considered when implementing an effective and targeted preoperative assessment.

Trail registration: German Clinical Trials Registry at https://www.drks.de/DRKS00028614 , Registered 25 March 2022.

Keywords: Geriatric assessment; Malnutrition; POD; Surgery.

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Conflict of interest statement

Declarations. Ethical approval: This study was approved by the ethics review board of University Hospital of Düsseldorf (2022−1810_2) and all the participants provided written informed consent. Informed consent: Written informed consent has been obtained from the patients. Competing interests: The authors declare no competing interests.

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