Conclusion Geriatric syndromes are important prognostic factors for postoperative complications .
Background Elective surgeries can be associated with significant harm to older adults .
The present study aim ed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery .
Preoperative cognitive dysfunction is related to adverse postoperative outcomes in the elderly.
BACKGROUND Preoperative risk stratification is commonly performed by assessing end-organ function ( such as cardiac and pulmonary ) to define postoperative risk . Little is known about impaired preoperative cognition and outcomes . The purpose of this study was to evaluate the impact of baseline impaired cognition on postoperative outcomes in geriatric surgery patients . STUDY DESIGN Subjects 65 years and older undergoing a planned elective operation requiring postoperative ICU admission were recruited prospect ively .  Preoperative baseline cognition was assessed using the vali date d Mini-Cog test . Impaired cognition was defined as a Mini-Cog score of ≤ 3 . Delirium was assessed using the Confusion Assessment Method -ICU by a trained research team . Adverse outcomes were defined using the Veterans Affairs Surgical Quality Improvement Program definitions . RESULTS One hundred and eighty-six subjects were included , with a mean age of 73 ± 6 years . Eighty-two subjects ( 44 % ) had baseline impaired cognition . The impaired cognition group had the following unadjusted outcomes : increased incidence of 1 or more postoperative complications ( 41 % vs 24 % ; p = 0.011 ) , higher incidence of delirium ( 78 % vs 37 % ; p < 0.001 ) , longer hospital stays ( 15 ± 14 vs 9 ± 9 days ; p = 0.001 ) , higher rate of discharge institutionalization ( 42 % vs 18 % ; p = 0.001 ) , and higher 6-month mortality ( 13 % vs 5 % ; p = 0.040 ) . Adjusting for potential confounders determined by univariate analysis , logistic regression found impaired cognition was still associated with the occurrence of 1 or more postoperative complications ( odds ratio = 2.401 ; 95 % CI , 1.185 - 4.865 ; p = 0.015 ) . Kaplan-Meier survival analysis revealed higher mortality in the impaired cognition group ( log-rank p = 0.008 ) . CONCLUSIONS Baseline cognitive impairment in older adults undergoing major elective operations is related to adverse postoperative outcomes including increased complications , length of stay , and long-term mortality . Improved underst and ing of baseline cognition and surgical outcomes can aid surgical decision making in older adults
Conclusion Geriatric syndromes are important prognostic factors for postoperative complications .
Background Elective surgeries can be associated with significant harm to older adults .
The present study aim ed to identify the prognostic factors associated with the development of postoperative complications among older adults undergoing elective surgery .