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Acta Anaesthesiol Scand. 2016 Nov;60(10):1404-1414. doi: 10.1111/aas.12779. Epub 2016 Aug 31.

No convincing association between post-operative delirium and post-operative cognitive dysfunction: a secondary analysis.

Author information

1
Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
2
Department of Medical Statistics, Informatics and Documentation, University Hospital Jena, Jena, Germany.
3
Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany. fmr@regionsjaelland.dk.
4
Anaestesiafdelingen, Naestved Sygehus, Naestved, Denmark. fmr@regionsjaelland.dk.

Abstract

BACKGROUND:

Post-operative delirium and post-operative cognitive dysfunction (POCD) are both common but it has not been clarified how closely they are associated. We aimed to assess the possible relationship in a secondary analysis of data from the 'Surgery Depth of anaesthesia and Cognitive outcome'- study.

METHODS:

We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min. Delirium was assessed according to the Diagnostic and Statistical Manual of Mental Disorders IV criteria in the post-anaesthesia care unit (PACU) as well as within the first week after surgery. Cognitive function was assessed with a neuropsychological test battery. Multivariable analysis of POCD was performed with consideration of predisposing and precipitating factors.

RESULTS:

Of 1277 randomized patients, 850 (66.6%) had complete data. Delirium was found in 270 patients (32.9% of 850). We detected POCD in 162 (20.9% of 776) at 1 week and in 52 (9.4% of 553) at 3 months. In multivariable analysis (n = 808), delirium had no overall effect on POCD (P = 0.30). Patients with no delirium in PACU but with postoperative delirium within 7 days had an increased risk of POCD at 3 months (OR = 2.56 (95%-confidence interval: 1.07-6.16), P = 0.035). No significant association was found for the other subgroups.

CONCLUSIONS:

There is no clear evidence that postoperative delirium is independently associated with POCD up to 3 months.

PMID:
27578364
DOI:
10.1111/aas.12779
[Indexed for MEDLINE]

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