|
|||||
|
|
Delirium is associated with early postoperative cognitive dysfunction |
|
| Authors: | Rudolph J L Marcantonio E R Culley D J Silverstein J H Rasmussen L S Crosby G J Inouye S K |
| Institution: | Assistant Professor of Medicine, VA Boston Healthcare System, Geriatric Education and Clinical Center;Brigham and Women's Hospital, Division of Aging, Harvard Medical School, Boston, MA, USA; Associate Professor of Medicine, Beth Israel Deaconess Medical Center, Divisions of General Medicine and Primary Care and Gerontology, Harvard Medical School, Boston, MA, USA; Assistant Professor of Anaesthesia, Brigham and Women's Hospital, Department of Anesthesiology, Harvard Medical School, Boston, MA, USA; Professor, Departments of Anesthesiology, Surgery, and Geriatrics &Adult Development, Mount Sinai School of Medicine, NY, USA; Associate Professor, Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Associate Professor of Anaesthesia, Brigham and Women's Hospital, Department of Anesthesiology, Harvard Medical School, Boston, MA, USA; Professor of Medicine, Hebrew Senior Life Aging Brain Center and Institute for Aging Research, Beth Israel Deaconess Medical Center, Division of Gerontology, Harvard Medical School, Boston, MA, USA |
| Abstract: | The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects ≥ 60 years old undergoing elective, non-cardiac surgery. Postoperatively, subjects were evaluated for delirium using the criteria of the Diagnostic and Statistical Manual. Subjects underwent neuropsychological testing pre-operatively and postoperatively at 7 days ( n = 1018) and 3 months ( n = 946). Postoperative cognitive dysfunction was defined as a composite Z -score > 2 across tests or at least two individual test Z -scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1–2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6–2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive dysfunction remains unclear. |
| Keywords: | |
| 本文献已被 PubMed 等数据库收录！ | |