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

Autor: Franck M; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany., Nerlich K; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany., Neuner B; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany., Schlattmann P; Department of Medical Statistics, Informatics and Documentation, University Hospital Jena, Jena, Germany., Brockhaus WR; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany., Spies CD; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany., Radtke FM; Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany. fmr@regionsjaelland.dk.; Anaestesiafdelingen, Naestved Sygehus, Naestved, Denmark. fmr@regionsjaelland.dk.
Jazyk: angličtina
Zdroj: Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2016 Nov; Vol. 60 (10), pp. 1404-1414. Date of Electronic Publication: 2016 Aug 31.
DOI: 10.1111/aas.12779
Abstrakt: 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.
(© 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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