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Table 5 Factors associated with functional decline 3 months after surgery

From: Postoperative cognitive dysfunction in older surgical patients associated with increased healthcare utilization: a prospective study from an upper-middle-income country

Variable

Univariate analysis

Crude RR (95% CI)

P-value

Multivariate analysis

Adjusted RRa (95% CI)

P-value

Cognition

No cognitive change (n = 163)

1

 

1

 

POCD (n = 37)

0.96 (0.51–1.81)

0.91

1.01 (0.49–2.09)

0.96

POD (n = 26)

2.44 (1.63–3.66)

 < 0.05*

2.33 (1.15–4.71)

0.02*

POCD with POD (n = 14)

1.49 (1.01–2.21)

0.14

1.33 (0.50–3.55)

0.56

Preoperative frailty

(n = 31)

0.99 (0.55–1.79)

1.00

–

–

Preoperative Barthel ADL Index; score ≤ 70 (n = 9)

1.14 (0.44–2.95)

0.72

–

–

Preoperative Modified IQCODE

 ≥ 3.42 (n = 37)

0.94 (0.53–1.67)

0.85

–

–

Female

(n = 100)

1.05(0.70–1.56)

0.89

1.22 (0.73–2.04)

0.45

Age ≥ 75 years

(n = 85)

1.14 (0.76–1.71)

0.55

1.04 (0.62–1.76)

0.88

Charlson comorbidity index

 ≥ 5 (n = 183)

1.24 (0.75–2.06)

0.41

–

–

Baseline PHQ-9

 ≥ 7 (n = 12)

1.15 (0.50–2.62)

0.75

–

–

Cardiac surgery (n = 136)

1.14 (0.76–1.71)

0.57

0.73 (0.44–1.29)

0.26

Postoperative complications

(n = 240)

Pneumonia

(n = 12)

1.78 (0.97–3.25)

0.19

0.53 (0.14–1.94)

0.34

Acute kidney injury

(n = 24)

2.25 (1.49–3.37)

 < 0.05*

1.93 (0.77–4.84)

0.16

Arrhythmia

(n = 48)

1.60 (1.06–2.41)

0.01*

0.93 (0.49–1.76)

0.82

Urinary tract infection

(n = 6)

1.74 (0.76–3.98)

0.36

–

–

Convulsion

(n = 3)

1.14 (0.22–5.74)

1.00

–

–

Reoperation

(n = 14)

2.08 (1.26–3.43)

0.03*

1.19 (0.35–4.04)

0.78

  1. * Indicates statistical significance (< 0.05)
  2. POCD includes participants who had MoCA administered 1 week after surgery to establish their POCD status but did not include patients with POD
  3. POD includes participants who had DSM-5 administered to establish their POD status but did not include patients with POCD
  4. POCD with POD includes participants who had MoCA administered 1 week after surgery and DSM-5 administered to establish their POCD status and POD status, respectively
  5. aThe model adjusted for gender, age, type of surgery, pneumonia, acute kidney injury, arrhythmia, and reoperation
  6. Abbreviations:Barthel ADL Barthel activities of daily living, POCD postoperative cognitive dysfunction, POD postoperative delirium