{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:57:15Z","timestamp":1791338235377,"version":"4.3.1"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T00:00:00Z","timestamp":1680566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The association of frailty with postoperative delirium has not been fully investigated in patients undergoing cardiovascular surgery. Therefore, this study aimed to investigate whether preoperative hand grip strength is associated with postoperative delirium. This retrospective study included patients aged &gt;65 years who had undergone elective cardiovascular surgery using cardiopulmonary bypass at a Japanese university hospital between April 2020 and February 2022. We defined low hand grip strength as hand grip values of &lt;275 n and &lt;177 n for men and women, respectively. Postoperative delirium was assessed using the confusion assessment method during patients\u2019 intensive care unit stay. The odds ratio of low hand grip strength for postoperative delirium was estimated using multiple logistic analysis, which was adjusted for prominent clinical factors. Ninety-five patients with a median age of 74 years were included in the final analysis, and 31.5% of them had low hand grip strength. Postoperative delirium occurred in 37% of patients, and the odds ratio of low preoperative hand grip strength for postoperative delirium was 4.58 (95% confidence interval: 1.57\u201313.2). Thirty-seven patients experienced postoperative delirium after cardiovascular surgery using cardiopulmonary bypass, and low preoperative hand grip strength was positively associated with its occurrence.<\/jats:p>","DOI":"10.3390\/jcm12072705","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T01:39:26Z","timestamp":1680658766000},"page":"2705","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association between Preoperative Hand Grip Strength and Postoperative Delirium after Cardiovascular Surgery: A Retrospective Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Taichi","family":"Kotani","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5285-257X","authenticated-orcid":false,"given":"Mitsuru","family":"Ida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoki","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Fukushima Medical University, Fukushima 960-1295, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/ajhp\/70.1.53","article-title":"Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the Intensive Care Unit: Executive summary","volume":"70","author":"Barr","year":"2013","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.jtcvs.2014.10.118","article-title":"The impact of frailty on postoperative delirium in cardiac surgery patients","volume":"149","author":"Jung","year":"2015","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Brown CH 4th Max, L., LaFlam, A., Kirk, L., Gross, A., Arora, R., Neufeld, K., Hogue, C.W., Walston, J., and Pustavoitau, A. (2016). The Association Between Preoperative Frailty and Postoperative Delirium After Cardiac Surgery. Anesth. Analg., 123, 430\u2013435.","DOI":"10.1213\/ANE.0000000000001271"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: Evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Pe\u00f1a, C., Garc\u00eda-Fabela, L.C., Guti\u00e9rrez-Robledo, L.M., Garc\u00eda-Gonz\u00e1lez, J.J., Arango-Lopera, V.E., and P\u00e9rez-Zepeda, M.U. (2013). Handgrip strength predicts functional decline at discharge in hospitalized male elderly: A hospital cohort study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0069849"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/ags3.12519","article-title":"Grip strength as a predictor of postoperative delirium in patients with colorectal cancers","volume":"6","author":"Arita","year":"2022","journal-title":"Ann. Gastroenterol. Surg."},{"key":"ref_7","first-page":"684","article-title":"Risk model of valve surgery in Japan using the Japan Adult cardiovascular Surgery Database","volume":"19","author":"Motomura","year":"2010","journal-title":"J. Heart Valve Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/ggi.14005","article-title":"The revised Japanese version of the Cardiovascular Health Study criteria (revised J-CHS criteria)","volume":"20","author":"Satake","year":"2020","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1001\/jama.286.21.2703","article-title":"Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the Intensive Care Unit (CAM-ICU)","volume":"286","author":"Ely","year":"2001","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1055\/s-2001-13834","article-title":"Multidisciplinary management of sedation and analgesia in critical care","volume":"22","author":"Sessler","year":"2001","journal-title":"Semin. Respir Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s13019-021-01496-w","article-title":"Risk factors of postoperative delirium after cardiac surgery: A meta-analysis","volume":"16","author":"Chen","year":"2021","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2188\/jea.JE20180137","article-title":"Decline in handgrip strength from midlife to late-life is associated with dementia in a Japanese community: The Hisayama study","volume":"30","author":"Hatabe","year":"2020","journal-title":"J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.3233\/JAD-170380","article-title":"Delayed recall and working memory MMSE domains predict delirium following cardiac surgery","volume":"59","author":"Price","year":"2017","journal-title":"J. Alzheimers Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/HCR.0b013e31824bd886","article-title":"Upper and lower extremity muscle strength levels associated with an exercise capacity of 5 metabolic equivalents in male patients with heart failure","volume":"32","author":"Izawa","year":"2012","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1053\/j.jvca.2020.12.051","article-title":"Six-minute walk test predicts postoperative delirium after transcatheter aortic valve replacement","volume":"35","author":"Yamashita","year":"2021","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Steenblock, J., Braisch, U., Brefka, S., Thomas, C., Eschweiler, G.W., Rapp, M., Metz, B., Maurer, C., von Arnim, C.A.F., and Herrmann, M.L. (2023). Frailty index and its association with the onset of postoperative delirium in older adults undergoing elective surgery. BMC Geriatr., 23.","DOI":"10.1186\/s12877-022-03663-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/S0140-6736(13)60688-1","article-title":"Delirium in elderly people","volume":"8","author":"Inouye","year":"2014","journal-title":"Lancet"},{"key":"ref_18","first-page":"S0022-5223(21)01126-0","article-title":"Prevention of postoperative delirium after cardiovascular surgery: A team-based approach","volume":"24","author":"Enomoto","year":"2021","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1089\/rej.2018.2111","article-title":"The association of handgrip strength and mortality: What does it tell us and what can we do with it?","volume":"22","author":"Buckner","year":"2019","journal-title":"Rejuvenation Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1001\/jama.2012.6857","article-title":"Postoperative delirium: A 76-year-old woman with delirium following surgery","volume":"308","author":"Marcantonio","year":"2012","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1001\/archinte.161.20.2467","article-title":"Nurses\u2019 recognition of delirium and its symptoms: Comparison of nurse and researcher ratings","volume":"161","author":"Inouye","year":"2001","journal-title":"Arch. Intern. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1177\/147323001003800503","article-title":"Delayed treatment of delirium increases mortality rate in intensive care unit patients","volume":"38","author":"Heymann","year":"2010","journal-title":"J. Int. Med. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1002\/cncr.24215","article-title":"Impact of delirium and recall on the level of distress in patients with advanced cancer and their family caregivers","volume":"115","author":"Bruera","year":"2009","journal-title":"Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.ijsu.2015.04.080","article-title":"Postoperative delirium in elderly after elective and acute colorectal surgery: A prospective cohort study","volume":"18","author":"Raats","year":"2015","journal-title":"Int. J. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2705\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:10:02Z","timestamp":1760123402000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/7\/2705"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,4]]},"references-count":24,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12072705"],"URL":"https:\/\/doi.org\/10.3390\/jcm12072705","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,4]]}}}