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Multicenter Study
. 2008 Sep;63(9):941-7.
doi: 10.1111/j.1365-2044.2008.05523.x. Epub 2008 Jun 10.

Delirium is associated with early postoperative cognitive dysfunction

J L Rudolph  1 , E R Marcantonio, D J Culley, J H Silverstein, L S Rasmussen, G J Crosby, S K Inouye
Affiliations
Multicenter Study

Delirium is associated with early postoperative cognitive dysfunction

J L Rudolph et al. Anaesthesia. 2008 Sep.

Abstract

The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects >or= 60 years old undergoing elective, non-cardiac surgery. Postoperatively, subjects were evaluated for delirium using the criteria of the Diagnostic and Statistical Manual. Subjects underwent neuropsychological testing pre-operatively and postoperatively at 7 days (n = 1018) and 3 months (n = 946). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1-2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6-2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive dysfunction remains unclear.

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