PMID- 37735216
OWN - NLM
STAT- MEDLINE
DCOM- 20240202
LR  - 20240206
IS  - 1432-0932 (Electronic)
IS  - 0940-6719 (Linking)
VI  - 33
IP  - 1
DP  - 2024 Jan
TI  - Comprehensive geriatric assessment to predict adverse events in elderly patients 
      undergoing posterior lumbar fusion surgery.
PG  - 274-281
LID - 10.1007/s00586-023-07945-5 [doi]
AB  - PURPOSE: Although comprehensive geriatric assessment (CGA) has been used widely, 
      its impact on adverse events in elderly patients has not been fully examined. The 
      present study aimed to investigate the relationships between subcomponents of CGA 
      and adverse events (AEs) in elderly patients undergoing posterior lumbar fusion 
      surgery. METHODS: A total of 242 eligible elderly patients enrolled. Our CGA 
      included activities of daily living, instrumental activities of daily living, 
      nutritional status, cardiac function, pulmonary function, renal function, 
      frailty, cognition, anxiety, depression, delirium, chronic pain score, 
      comorbidity and polypharmacy. Comprehensive complication index was used to 
      summarize postoperative complications and its severity. Logistic regression was 
      performed to determine the relationships between subcomponents of a CGA and 
      postoperative AEs. RESULTS: Present study found that female were more vulnerable 
      to have AEs. Postoperative major AEs were associated with delirium (odds ratio 
      (OR): 4.302, 95% confidence interval (CI) 1.720-10.761, p = 0.002), nutritional 
      status (OR: 3.030, 95%CI 1.218-7.541, p = 0.017), cognitive impairment (OR: 
      4.122, 95%CI 1.179-14.407, p = 0.027), Charlson comorbidity index (CCI) (OR: 
      4.800, 95%CI 1.852-12.440, p = 0.001) and severe dependent (OR: 3.772, 95%CI 
      1.116-9.841, p = 0.007). Further analysis showed that delirium (OR: 2.824, 95%CI 
      1.068-7.467, p = 0.036) and CCI (OR: 3.221, 95%CI 1.184-8.766, p = 0.022) were 
      independently related to major AEs. CONCLUSIONS: These results indicate that 
      preoperative screening preoperative delirium, cognitive, nutrition and CCI are 
      essential to prevent postoperative major AEs of the surgical elderly.
CI  - (c) 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Cui, Peng
AU  - Cui P
AUID- ORCID: 0000-0002-1636-4832
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China.
FAU - Liu, Ting
AU  - Liu T
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China.
FAU - Wang, Zheng
AU  - Wang Z
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China.
FAU - Wang, Shuaikang
AU  - Wang S
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China.
FAU - Wang, Peng
AU  - Wang P
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China.
FAU - Kong, Chao
AU  - Kong C
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China. kong988500@163.com.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China. kong988500@163.com.
FAU - Lu, Shibao
AU  - Lu S
AD  - Department of Orthopedics, Xuanwu Hospital Capital Medical University, Beijing, 
      People's Republic of China. spinelu@xwhosp.org.
AD  - National Clinical Research Center for Geriatric Diseases, Beijing, People's 
      Republic of China. spinelu@xwhosp.org.
LA  - eng
GR  - DFL20190802/Beijing Hospitals Authority's Ascent Plan/
GR  - XMLX202116/Beijing Hospitals Authority Clinical Medicine Development of Special 
      Funding Support/
PT  - Journal Article
DEP - 20230921
PL  - Germany
TA  - Eur Spine J
JT  - European spine journal : official publication of the European Spine Society, the 
      European Spinal Deformity Society, and the European Section of the Cervical Spine 
      Research Society
JID - 9301980
SB  - IM
MH  - Humans
MH  - Female
MH  - Aged
MH  - Geriatric Assessment/methods
MH  - Activities of Daily Living
MH  - *Frailty/complications
MH  - Postoperative Complications/epidemiology/etiology
MH  - *Delirium/complications/diagnosis
OTO - NOTNLM
OT  - Adverse events
OT  - Comprehensive geriatric assessment
OT  - Elderly patients
OT  - Lumbar fusion
EDAT- 2023/09/22 00:42
MHDA- 2024/02/02 06:43
CRDT- 2023/09/21 23:41
PHST- 2022/09/21 00:00 [received]
PHST- 2023/09/04 00:00 [accepted]
PHST- 2022/09/21 00:00 [revised]
PHST- 2024/02/02 06:43 [medline]
PHST- 2023/09/22 00:42 [pubmed]
PHST- 2023/09/21 23:41 [entrez]
AID - 10.1007/s00586-023-07945-5 [pii]
AID - 10.1007/s00586-023-07945-5 [doi]
PST - ppublish
SO  - Eur Spine J. 2024 Jan;33(1):274-281. doi: 10.1007/s00586-023-07945-5. Epub 2023 
      Sep 21.