Cardiovascular health score and its association with postoperative delirium: evidence from the Kailuan study

Identifying modifiable risk factors for postoperative delirium (POD) is essential for prevention and management. The Ideal Cardiovascular Health Score (CHS), a composite measure of cardiovascular health, has been shown to reduce the risk of various chronic diseases. However, its association with POD has not been extensively explored. This study aims to examine the relationship between CHS and the risk of POD in a cohort of surgical patients.

Data from the Kailuan Study, a large longitudinal cohort, were used for this analysis. A total of 1,082 participants aged 18-98 years, who underwent non-cardiac surgery under general anesthesia from 2016 to 2021, were included. The CHS was calculated based on seven cardiovascular health metrics: smoking status, body mass index (BMI), physical activity, diet, blood pressure, fasting blood glucose (FBG), and total cholesterol (TC). POD was diagnosed using the Confusion Assessment Method (CAM). Multivariable logistic regression was employed to assess the association between CHS scores and POD, adjusting for potential confounders.

Among the 1,082 participants, 120 developed POD. Higher CHS scores were inversely associated with the risk of POD. Participants with a CHS ≥ 10 had 55% lower odds of developing POD compared to those with a CHS ≤ 7 (OR = 0.45; 95% CI: 0.23-0.89). This protective effect was observed across various subgroups, including age, sex, and alcohol consumption status. Specific CHS components, such as normal blood pressure (OR = 0.49; 95% CI: 0.31-0.78) and FBG < 5.6 mmol/L (OR = 0.65; 95% CI: 0.47-0.94), were independently associated with reduced POD risk.

A higher CHS score is associated with a lower risk of POD, highlighting the potential protective role of cardiovascular health in preventing postoperative complications.