The Potential Value of Prehabilitation for Preventing Delirium in Elective Surgery for Aneurysms of the Abdominal Aorta

Figures & data

Table 1 Baseline Characteristics and Results of the Total Group

		Total group n = 204 (100%)
		Control	Prehabilitation	Total	P-value
		n = 81 (39.7%)	n = 123 (60.3%)	n = 204
Baseline characteristics
Demographics	Age	75 (72–80)	77 (73–81)	76 (73–81)	0.15
	Gender (male)	70 (86.4)	105 (85.4)	175 (85.8)	0.83
Medical history	Cognitive impairment	3 (3.7)	1 (0.8)	4 (2)	0.15
	History of delirium	2 (2.5)	9 (7.3)	11 (5.4)	0.13
	CCI ≤7	21 (25.9)	41 (33.3)	62 (30.4)	0.26
	ASA ≤3	53 (65.4)	95 (77.2)	148 (72.5)	0.07
Physical impairment	KATZ-ADL ≤1	7 (8.6)	19 (15.4)	26 (12.7)	0.15
	SNAQ-RC ≤ 3	6 (7.4)	5 (4.1)	11 (5.4)	0.024
	Visual impairment	17 (21)	53 (43.1)	70 (34.3)	0.005
	Hearing impairment	25 (30.9)	50 (40.7)	75 (36.8)	0.27
Intoxications	Daily alcohol use	31 (38.3)	51 (41.5)	82 (40.2)	0.43
	Active smoker	25 (32.1)	28 (22.8)	53 (26)	0.15
Type of surgery	Open AAA	31 (38.3)	41 (33.3)	72 (35.3)	0.47
	EVAR	50 (61.7)	82 (66.7)	132 (64.7)	0.47
Results
Primary outcome	Incidence of delirium	9 (11.1)	6 (4.9)	15 (7.4)	0.09
	Duration of delirium in days	3 (2–8)	4 (3–8)	3.5 (2.3–10.3)	0.67
Complications	Any complications other than delirium	27 (33.3)	46 (37.4)	73 (35.8)	0.55
	Clavien-Dindo-I-II	17 (21)	30 (24.4)	47 (23)	0.57
	Clavien-Dindo-III-V	10 (38.5)	16 (61.5)	26 (12.7)	0.89
	Multiple complications	6 (7.4)	11 (8.9)	17 (8.3)	0.70
ICU stay	Unplanned ICU admission	11 (13.6)	14 (11.4)	25 (12.3)	0.64
	ICU length of stay - days	5 (2–6.5)	4 (2–6)	5 (2–6.5)	0.87
Stay and readmission	Length of stay - days	5 (4–8)	4 (3–7.5)	4 (3–8)	0.02
	30-day readmission^a	3 (3.9)	11 (9.1)	0.17	0.17
Mortality	Mortality during admission	5 (6.2)	2 (1.6)	7 (3.4)	0.08
	30-day mortality	4 (4.9)	3 (2.4)	7 (3.4)	0.34

Notes: Data are presented as n (%) or median (interquartile range). ^aCalculated over the patients that did not decease during admission.

Abbreviations: CCI, Charlson Comorbidity Index; ASA, American Society of Anesthesiology; KATZ-ADL, Katz index of Independence in Activities of Daily Living; SNAQ-RC, Short Nutritional Assessment Questionnaire for Residential Care; AAA, Aneurysm of the Abdominal Aorta; EVAR, Endovascular Aorta Repair; ICU, Intensive Care Unit.

Table 2 Subgroup Analysis: Stratified for Open AAA Repair and EVAR

		Open Repair, n = 72 (35.3%)			EVAR, n = 132 (64.7%)
		Control	Prehabilitation	P-value	Control	Prehabilitation	P-value
		n=31 (43.1%)	n=41 (56.9%)		n=50 (37.9%)	n=82 (62.1%)
Primary outcome	Incidence of delirium	8 (25.8)	5 (12.2)	0.14	1 (2)	1 (1.2)	0.72
	Duration of delirium in days, median (IQR)	4 (2.5–9.5)	3.5 (3–4)	0.74	2 (-)	22 (-)	0.32
Complications	Any complications other than delirium	16 (51.6)	21 (51.2)	0.97	11 (22)	25 (30.5)	0.29
	Clavien-Dindo-I-II	9 (29)	9 (22)	0.49	8 (16)	21 (25.6)	0.20
	Clavien-Dindo-III-V	7 (22.6)	12 (29.3)	0.52	3 (6)	4 (4.9)	0.78
	Multiple complications	6 (19.4)	9 (22)	0.79	0 (0)	2 (2.4)	0.27
ICU stay	Unplanned ICU admission	10 (32.2)	13 (31.7)	0.96	1 (2)	1 (1.2)	0.72
	ICU length of stay, days, median (IQR)	5 (2–7)	4 (3–6)	0.66	1 (?)	2 (?)	0.32
Stay and readmission	Length of stay in days, median (IQR)	9 (7–14)	11 (6–14)	0.68	4 (3–5)	3 (3–4)	<0.001
	30-day readmission^a	1 (3.7)	3 (7.7)	0.50	2 (4.1)	8 (9.8)	0.24
Mortality	Mortality during admission	4 (12.9)	2 (2.8)	0.22	1 (2)	0 (0)	0.20
	30-day mortality	3 (9.7)	2 (4.9)	0.43	1 (2)	1 (1.2)	0.72

Notes: Data are presented as n (%) or median (interquartile range). ^aCalculated over the patients that did not decease during admission.

Abbreviations: EVAR, Endovascular Aorta Repair; ICU, Intensive Care Unit.