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Preoperative Cognitive Performance andPostoperative Delirium Are independentlyAssociated With Future Dementia in OlderPeople Who Have Undergone Cardiac Surgery:A Longitudinal Cohort Study
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing. Cardiothoracic Surgery Division, Heart Center.
Umeå University, Faculty of Medicine, Department of Nursing.
Umeå University, Faculty of Medicine, Department of Nursing.
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2017 (English)Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To investigate if postoperative delirium was associated with the development of dementia within 5 years after cardiac surgery.

Design: Longitudinal cohort study.

Setting: Cardiothoracic Division, Umea University Hospital, Sweden.

Patients: Patients aged 70 years old or older (n = 114) scheduled for routine cardiac procedures with cardiopulmonary bypass without documented dementia were enrolled in 2009.

Intervention: Structured assessments were performed preoperatively, 1 and 4 days after extubation, and 1, 3, and 5 years postoperatively.

Measurements and Main Results: Patients were assessed comprehensively, including cognitive and physical function, coexisting medical conditions, demographic characteristics, and medications. Diagnoses of delirium, depression, and dementia were made according to Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criteria. During the 5-year period, 30 of 114 participants (26.3%) developed dementia. Postoperative delirium had occurred in 87% of those who later developed dementia. A multivariable logistic regression model showed a lower preoperative Mini-Mental State Examination score (p < 0.001; odds ratio, 0.68; 95% CI, 0.54-0.84) and the occurrence of postoperative delirium (p = 0.002; odds ratio, 7.57; 95% CI, 2.15-26.65) were associated with dementia occurrence.

Conclusions: Our findings suggest that older patients with reduced preoperative cognitive functions or who develop postoperative delirium are at risk of developing dementia within 5 years after cardiac surgery. Cognitive functions should be screened for preoperatively, those who develop postoperative delirium should be followed up to enable early detection of dementia symptoms, and management should be implemented.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Place, publisher, year, edition, pages
2017.
Keyword [en]
cardiac surgery; cardiovascular disease; delirium; dementia, older people
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-135501DOI: 10.1097/CCM.0000000000002483OAI: oai:DiVA.org:umu-135501DiVA: diva2:1102660
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2017-05-30

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Publisher's full texthttp://journals.lww.com/ccmjournal/Abstract/publishahead/Preoperative_Cognitive_Performance_and.96599.aspx

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Claesson Lingehall, HelenaSmulter, NinaLindahl, ElisabethLindkvist, MarieOlofsson, Birgitta
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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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