Optimization of the cardiac delirium index by including age, decrease in butyrylcholinesterase actitivity, preoperative HbA1c, and postoperative hemoglobin levels: results of a secondary analysis of a prospective observational study

Despite the small size of this derivation cohort, this study identified elevated HbA1c as the strongest risk factor for the development of POD, followed by a decrease in BChE activity, postoperative anemia, and age, respectively. By including these parameters to the CARDEL index, its predictive power for the identification of POD significantly improved in this derivation cohort. Moving forward, integrating these findings into clinical practice could enhance early risk stratification and targeted intervention for patients at high risk of POD. Therefore, further research should evaluate these results in a larger, external cohort.