FRAILTY AND ASA SCORE AS INDEPENDENT PREDICTORS OF EARLY POSTOPERATIVE COGNITIVE DYSFUNCTION IN OLDER SURGICAL PATIENTS: A PROSPECTIVE COHORT STUDY
Bibliographic record
Abstract
Introduction: As the global population ages, the prevalence of agerelated decline and geriatric syndromes has increased. Postoperative cognitive dysfunction is a frequent but under-recognized complication in older patients. Frailty, characterized by reduced physiological reserve, may heighten vulnerability to cognitive decline after hospitalization and surgery. Although both conditions have been studied separately, their direct association remains unclear. This study investigated the relationship between frailty, geriatric syndromes, and postoperative cognitive dysfunction to improve understanding of perioperative cognitive vulnerability. Materials and Method: A total of 305 patients aged ≥65 years were classified into four groups: outpatients, patients without recent surgery, and surgical patients under spinal or general anesthesia. Frailty was assessed with the Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight scale and the 11-item Modified Frailty Index. Cognitive function was evaluated with the Montreal Cognitive Assessment at baseline and on day three. A decline of more than one standard deviation was defined as postoperative cognitive dysfunction. Results: Postoperative cognitive dysfunction occurred in 46% of patients. Univariate analysis showed associations with age, chronic disease, geriatric syndromes, American Society of Anesthesiologists physical status score, and frailty. Multivariate analysis identified age, American Society of Anesthesiologists score, and frailty as independent predictors. Patients aged ≥85 years and those in American Society of Anesthesiologists class III had 11.6- and 3.2-fold higher risk, respectively. Frail and pre-frail individuals had 11.3- and 4.2-fold higher risk, respectively Conclusion:Advanced age, higher American Society of Anesthesiologists score, and frailty markedly increased the risk of postoperative cognitive dysfunction. Routine frailty screening may help identify vulnerable patients and guide preventive strategies. Keywords: Geriatrics; Frailty; Neuropsychological Tests; Cognitive Dysfunction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".