BMI, Comorbidity Burden, and Postoperative Delirium in Older Adults: A Retrospective Cohort Study

Vollständiger Abstract

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BACKGROUND: Postoperative delirium (POD) is a serious complication in older surgical patients. Although both body mass index (BMI) and comorbidity burden influence perioperative outcomes, it is unclear whether an “obesity paradox” applies to POD and, crucially, whether comorbidity burden modifies that relationship. We therefore examined the independent association of BMI with POD and formally tested whether comorbidity burden, measured by the Charlson Comorbidity Index (CCI), modifies this association in older adults. METHODS: This retrospective cohort study included 4320 patients aged ≥65 years who underwent noncardiac, non-neurological surgery under general anesthesia (2015–2024). Patients with BMI