Postoperative delirium is associated with grey matter brain volume loss.

Autor:	Kant IMJ; Department of Intensive Care Medicine and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands.; Department of Information Technology and Digital Innovation, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands., de Bresser J; Department of Radiology, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands., van Montfort SJT; Department of Intensive Care Medicine and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands., Witkamp TD; Department of Radiology and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands., Walraad B; Department of Intensive Care Medicine and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands., Spies CD; Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Berlin 10117, Germany., Hendrikse J; Department of Radiology and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands., van Dellen E; Department of Intensive Care Medicine and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands.; Department of Psychiatry and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands., Slooter AJC; Department of Intensive Care Medicine and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands.; Department of Psychiatry and University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht 3584 CX, The Netherlands.; Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Jette 1090, Belgium.
Jazyk:	angličtina
Zdroj:	Brain communications [Brain Commun] 2023 Jan 30; Vol. 5 (1), pp. fcad013. Date of Electronic Publication: 2023 Jan 30 (Print Publication: 2023).
DOI:	10.1093/braincomms/fcad013
Abstrakt:	Delirium is associated with long-term cognitive dysfunction and with increased brain atrophy. However, it is unclear whether these problems result from or predisposes to delirium. We aimed to investigate preoperative to postoperative brain changes, as well as the role of delirium in these changes over time. We investigated the effects of surgery and postoperative delirium with brain MRIs made before and 3 months after major elective surgery in 299 elderly patients, and an MRI with a 3 months follow-up MRI in 48 non-surgical control participants. To study the effects of surgery and delirium, we compared brain volumes, white matter hyperintensities and brain infarcts between baseline and follow-up MRIs, using multiple regression analyses adjusting for possible confounders. Within the patients group, 37 persons (12%) developed postoperative delirium. Surgical patients showed a greater decrease in grey matter volume than non-surgical control participants [linear regression: B (95% confidence interval) = -0.65% of intracranial volume (-1.01 to -0.29, P < 0.005)]. Within the surgery group, delirium was associated with a greater decrease in grey matter volume [B (95% confidence interval): -0.44% of intracranial volume (-0.82 to -0.06, P = 0.02)]. Furthermore, within the patients, delirium was associated with a non-significantly increased risk of a new postoperative brain infarct [logistic regression: odds ratio (95% confidence interval): 2.8 (0.7-11.1), P = 0.14]. Our study was the first to investigate the association between delirium and preoperative to postoperative brain volume changes, suggesting that delirium is associated with increased progression of grey matter volume loss. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.)
Databáze:	MEDLINE
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