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 .
Pre-existing cerebral infarcts as a risk factor for delirium after coronary artery bypass graft surgery.
OBJECTIVES Delirium is a common and critical clinical syndrome in older patients . We examined whether abnormalities in the brain that could be assessed by magnetic resonance imaging predisposed patients to develop delirium after coronary artery bypass graft surgery . We also analysed the association between delirium and cognitive dysfunction after coronary artery bypass graft surgery . METHODS Data were collected prospect ively on 153 patients aged 60 years or older who consecutively underwent elective isolated coronary artery bypass graft surgery . All patients were assessed for prior cerebral infa rct ions and craniocervical artery stenosis by magnetic resonance imaging ( MRI ) and angiography of their brains . Atherosclerosis of the ascending aorta was examined by epiaortic ultrasound at the time of surgery .  Individual cognitive status was measured using four tests in all the patients before surgery and on the seventh postoperative day . A single psychiatrist diagnosed delirium using the Diagnostic and Statistical Manual of Mental Disorders 4th edition IV criteria . RESULTS Postoperative delirium occurred in 16 patients ( 10.5 % ) . Compared with patients who did not develop postoperative delirium , delirious patients had significantly higher rates of peripheral artery disease , preoperative decline in global cognitive function and pre-existing multiple cerebral infa rct ions on MRI . In addition , 9 ( 56 % ) of the delirious patients suffered postoperative cognitive dysfunction . Stepwise logistic regression analysis found significant independent predictors of postoperative delirium to be preoperative cerebral infa rcts on MRI ( odds ratio [ OR ] , 2.26 ; 95 % confidence interval [ CI ] 1.10 - 4.78 ) , preoperative decline in global cognitive function ( OR 4.54 ; 95 % CI 1.21 - 16.51 ) and atherosclerosis of the ascending aorta ( OR 2.44 ; 95 % CI 1.03 - 5.62 ) . CONCLUSIONS Our findings suggested that postoperative delirium was associated with pre-existing multiple cerebral infa rct ions on MRI , preoperative decline in global cognitive function and ascending aortic atherosclerosis in elderly patients undergoing coronary artery bypass graft surgery and increased risk of postoperative cognitive dysfunction
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 .