Brain Health Screening in Older Surgical Patients: A Multicenter, Retrospective, Observational Analysis and Survey

Area of Science:

• Geriatric Medicine
• Perioperative Care
• Health Informatics

Background:

• Clinical guidelines advocate for routine perioperative screening of at-risk patients for cognitive impairment, frailty, and delirium.
• Integrating these geriatric screening variables into multicenter databases is crucial for advancing large-scale pragmatic research.

Purpose of the Study:

• To assess the retrievability of geriatric screening variables within the Multicenter Perioperative Outcomes Group (MPOG) database.
• To identify barriers to clinical implementation and digital capture of these screenings.

Main Methods:

• A retrospective analysis of the MPOG database for patients over 65 undergoing nonemergent inpatient surgery.
• A survey distributed to MPOG participant sites to evaluate current screening practices and perceived obstacles.

Main Results:

• Less than 1% of patient records contained preoperative cognitive screens; 13.6% had postoperative delirium screens; no frailty screens were found.
• Approximately 50% of surveyed institutions reported performing cognitive, frailty, or delirium screenings.
• A primary barrier identified was the lack of standardized screening tools integrated with electronic health records.

Conclusions:

• Minimal data collection for neurocognitive disorders contradicts clinical guidelines.
• Significant challenges exist in capturing geriatric screening data both locally and in multicenter datasets.
• Addressing these barriers is essential for facilitating future pragmatic research on this public health priority.