Preoperative MRI brain phenotypes are related to postoperative delirium in older individuals.

Autor: Kant IMJ; Department of Intensive Care Medicine, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands. Electronic address: i.kant-2@umcutrecht.nl., Slooter AJC; Department of Intensive Care Medicine, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands., Jaarsma-Coes M; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands., van Montfort SJT; Department of Intensive Care Medicine, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands., Witkamp TD; Department of Radiology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands., Pasma W; Department of Intensive Care Medicine, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands., Hendrikse J; Department of Radiology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands., de Bresser J; Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
Jazyk: angličtina
Zdroj: Neurobiology of aging [Neurobiol Aging] 2021 May; Vol. 101, pp. 247-255. Date of Electronic Publication: 2021 Feb 05.
DOI: 10.1016/j.neurobiolaging.2021.01.033
Abstrakt: The underlying structural correlates of predisposition to postoperative delirium remain largely unknown. A combined analysis of preoperative brain magnetic resonance imaging (MRI) markers could improve our understanding of the pathophysiology of delirium. Therefore, we aimed to identify different MRI brain phenotypes in older patients scheduled for major elective surgery, and to assess the relation between these phenotypes and postoperative delirium. Markers of neurodegenerative and neurovascular brain changes were determined from MRI brain scans in older patients (n = 161, mean age 71, standard deviation 5 years), of whom 24 (15%) developed delirium. A hierarchical cluster analysis was performed. We found six distinct groups of patients with different MRI brain phenotypes. Logistic regression analysis showed a higher odds of developing postoperative delirium in individuals with multi-burden pathology (n = 15 (9%), odds ratio (95% confidence interval): 3.8 (1.1-13.0)). In conclusion, these results indicate that different MRI brain phenotypes are related to a different risk of developing delirium after major elective surgery. MRI brain phenotypes could assist in an improved understanding of the structural correlates of predisposition to postoperative delirium.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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