Does Comprehensive Geriatric Assessment Reduce the Incidence of Postoperative Delirium? A Quasi-experimental Study in Older Adults Undergoing Transcatheter Aortic Valve Implantation

Figures & data

Table 1 Patients’ Characteristics

	Overall (n=435)	CGA group (n=254)	Non-CGA group (n=181)	P-value
Age (years), mean (SD)	81.0 (5.6)	81.4 (5.6)	80.5 (5.6)	0.127
Age categories, n (%)				0.138
<80 years	163 (42.5)	79 (38.9)	84 (46.4)
≥80 years	221 (57.6)	124 (61.1)	97 (53.6)
Sex, n (%)				0.117
Female	179 (43.6)	108 (47.0)	71 (39.2)
Male	232 (56.4)	122 (53.0)	110 (60.8)
BMI (kg/m^2), mean (SD)	27.4 (4.9)	27.2 (5.2)	27.5 (4.3)	0.233
No. of medication, median (IQR)	6.0 (4.0, 8.0)	6.0 (4.0, 7.0)	6.0 (4.0, 9.0)	0.055
Polypharmacy, n (%)				0.879
Not present (<5 meds)	140 (34.7)	78 (35.0)	62 (34.3)
Present (≥5 meds)	264 (65.4)	145 (65.0)	119 (65.8)
POD Incidence, n (%)	67 (16.3)	33 (14.3)	34 (18.8)	0.219
Self-care abilities (SPI) score, at admission (IQR)	40 (39, 40)	40 (39, 40)	40 (39, 40)	0.536
Self-care abilities (SPI) score, at discharge (IQR)	40 (37, 40)	40 (37, 40)	40 (37, 40)	0.483

Abbreviations: CGA, comprehensive geriatric assessment; SD, standard deviation; BMI, body mass index; No., number; IQR, interquartile range; POD, postoperative delirium; SPI, self-care Index. P-value calculated from chi-squared test for categorical data and the t-test or Wilcoxon rank sum test for continuous data depending on the normality of distribution.

Figure 1 Study Flow Diagram.

Abbreviations: CGA, comprehensive geriatric assessment; TAVI, transcatheter aortic valve implantation.

Table 2 Factors Associated with Postoperative Delirium (POD)

	Odds Ratio (95%CI)	P-value
Non-CGA vs CGA group	1.15 (0.65–2.04)	0.629
Age	1.05 (1.00–1.11)	0.050
Sex (female vs male)	0.49 (0.26–0.89)	0.019
BMI	0.98 (0.92–1.05)	0.546
No. of medications	1.13 (1.04–1.23)	0.006

Abbreviations: CGA, comprehensive geriatric assessment; BMI, body mass index; No., number. Association between POD and CGA was assessed by multivariate logistic regression model adjusted for age, sex, BMI, number of medications.

Table 3 Factors Associated with Change in Self-care Abilities (SPI)

	β Coefficient	SE	t Statistic	P-value
CGA group	0.21	0.44	0.47	0.639
SPI score at admission	−0.81	0.04	−19.00	<0.001
Age (per year)	−0.11	0.04	−2.87	0.004
Sex (female vs male)	0.17	0.44	0.38	0.704
BMI (per unit)	−0.04	0.05	−0.93	0.355
No. of medications	−0.28	0.07	−3.95	<0.001

Abbreviations: CGA, comprehensive geriatric assessment; SPI, self-care Index; BMI, body mass index; No., number; SE, standard error. Association between SPI and CGA assessed by linear regression model adjusted for age, sex, BMI, number of medications.