Study on the correlation between preoperative frailty and postoperative delirium or subdelirium syndrome in elderly lung cancer patients treated with radical resection

Objective To investigate the relationship between preoperative frailty and postoperative delirium or subsyndromal delirium in elderly patients after radical lung cancer surgery.

Methods By using the convenience sampling method, 454 elderly patients undergoing radical resection of lung cancer were selected as the research subjects. According to the preoperative Chinese version of the Tilburg Frailty Assessment Scale score, the patients were divided into the frailty group (115 cases) and non-frailty group (339 cases). The relevant clinical data of the patients were collected. Logistic regression analysis was used to screen the risk factors for the occurrence of postoperative delirium or subdelirium syndrome, and the ROC curve was used to analyze the predictive value of relevant indicators for postoperative delirium or subdelirium syndrome.

Results Among 454 elderly patients undergoing radical resection of lung cancer, 86 cases developed subdelirium syndrome, and 76 cases developed delirium. The incidence of postoperative delirium or subdelirium syndrome was 35.68% (162/454). Among them, the incidence of postoperative delirium or subdelirium syndrome in the frailty group was 67.83% (78/115), which was significantly higher than 24.78% (84/339) in the non-frailty group (P ＜ 0.01). After adjusting for factors such as living alone, educational level, postoperative hypothermia, and MMSE score, the risk of delirium or subdelirium syndrome in the frailty group was higher than that in the non-frailty group (OR = 6.971, 95%CI: 4.194–11.587), the AUC of the Chinese version of the Tilburg Flimsy Scale in predicting the occurrence of postoperative delirium or subdelirium syndrome in elderly patients undergoing radical resection of lung cancer was 0.677 (95%CI: 0.632–0.723).

Conclusions Preoperative frailty in elderly patients undergoing radical lung cancer surgery can increase the risk of postoperative delirium or subdelirium syndrome, and to a certain extent, it can predict the occurrence of postoperative delirium or subdelirium syndrome.