The Successful Aging after Elective Surgery (SAGES) Study: Cohort Description and Data Quality Procedures

Area of Science:

• Geriatric Medicine
• Neuroscience
• Surgical Complications

Background:

• Delirium is a common complication after major elective surgery in older adults.
• The Successful Aging after Elective Surgery (SAGES) study was initiated to investigate novel risk factors and long-term outcomes of delirium.
• This report details the SAGES cohort, quality assurance, and initial findings.

Purpose of the Study:

• To describe the cohort of older patients undergoing elective surgery within the SAGES study.
• To outline the quality assurance procedures implemented in the SAGES study.
• To present initial results regarding delirium incidence and study data quality.

Main Methods:

• A long-term prospective cohort study involving 566 patients aged 70+ undergoing elective major surgery across three academic medical centers.
• Comprehensive assessments including preoperative, daily in-hospital, and monthly post-discharge follow-ups for up to 36 months.
• Evaluation of delirium, cognitive and physical function, and novel risk factors (genetic, plasma, neuroimaging, cognitive reserve markers), with rigorous interrater reliability testing.

Main Results:

• The cohort averaged 77 years old, with 58% females; 81% had orthopedic surgery.
• Postoperative delirium occurred in 24% of patients.
• High follow-up rates (>95% for 18 months) and excellent data capture (>99% for outcomes) were achieved, with high interrater reliability (weighted kappas for delirium and outcomes >0.92).

Conclusions:

• The SAGES study provides a robust dataset for understanding delirium in older surgical patients.
• The study is well-positioned to elucidate novel risk factors, pathophysiology, and long-term consequences of delirium.
• This manuscript serves as a foundational reference for future research utilizing the SAGES cohort data.