Trail making test B in postoperative delirium: a replication study.
Geriatric anaesthesia
Open science
Perioperative medicine
Postoperative delirium
Replication
Risk prediction
Trail making test
Journal
BJA open
ISSN: 2772-6096
Titre abrégé: BJA Open
Pays: England
ID NLM: 9918419157906676
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
24
05
2023
revised:
28
08
2023
accepted:
16
10
2023
medline:
13
11
2023
pubmed:
13
11
2023
entrez:
13
11
2023
Statut:
epublish
Résumé
The Trail Making Test B (TMT-B) is indicative of cognitive flexibility and several other cognitive domains. Previous studies suggest that it might be associated with the risk of developing postoperative delirium, but evidence is limited and conflicting. We therefore aimed to replicate the association of preoperative TMT-B results with postoperative delirium. We included older adults (≥65 yr) scheduled for major surgery and without signs of dementia to participate in this binational two-centre longitudinal observational cohort study. Presurgical TMT-B scores were obtained. Delirium was assessed twice daily using validated instruments. Logistic regression was applied and the area under the receiver operating characteristic curve calculated to determine the predictive performance of TMT-B. We subsequently included covariates used in previous studies for consecutive sensitivity analyses. We further analysed the impact of outliers, missing or impaired data. Data from 841 patients were included and of those, 151 (18%) developed postoperative delirium. TMT-B scores were statistically significantly associated with the incidence of postoperative delirium {odds ratio per 10-s increment 1.06 (95% confidence interval [CI] 1.02-1.09), The TMT-B was associated with postoperative delirium, but its predictive performance as a stand-alone test was low. The TMT-B alone is not suitable to predict delirium in a clinical setting. NCT02265263. (https://clinicaltrials.gov/ct2/show/results/NCT02265263).
Sections du résumé
Background
UNASSIGNED
The Trail Making Test B (TMT-B) is indicative of cognitive flexibility and several other cognitive domains. Previous studies suggest that it might be associated with the risk of developing postoperative delirium, but evidence is limited and conflicting. We therefore aimed to replicate the association of preoperative TMT-B results with postoperative delirium.
Methods
UNASSIGNED
We included older adults (≥65 yr) scheduled for major surgery and without signs of dementia to participate in this binational two-centre longitudinal observational cohort study. Presurgical TMT-B scores were obtained. Delirium was assessed twice daily using validated instruments. Logistic regression was applied and the area under the receiver operating characteristic curve calculated to determine the predictive performance of TMT-B. We subsequently included covariates used in previous studies for consecutive sensitivity analyses. We further analysed the impact of outliers, missing or impaired data.
Results
UNASSIGNED
Data from 841 patients were included and of those, 151 (18%) developed postoperative delirium. TMT-B scores were statistically significantly associated with the incidence of postoperative delirium {odds ratio per 10-s increment 1.06 (95% confidence interval [CI] 1.02-1.09),
Conclusions
UNASSIGNED
The TMT-B was associated with postoperative delirium, but its predictive performance as a stand-alone test was low. The TMT-B alone is not suitable to predict delirium in a clinical setting.
Clinical trial registration
UNASSIGNED
NCT02265263. (https://clinicaltrials.gov/ct2/show/results/NCT02265263).
Identifiants
pubmed: 37954892
doi: 10.1016/j.bjao.2023.100239
pii: S2772-6096(23)00118-1
pmc: PMC10633257
doi:
Banques de données
ClinicalTrials.gov
['NCT02265263']
Types de publication
Journal Article
Langues
eng
Pagination
100239Informations de copyright
© 2023 The Author(s).
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