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Vol. 26, No. 1, 2008
Issue release date: July 2008
Section title: Original Research Article
Dement Geriatr Cogn Disord 2008;26:26–31
(DOI:10.1159/000140804)

High Risk of Cognitive and Functional Decline after Postoperative Delirium

A Three-Year Prospective Study

Bickel H. · Gradinger R. · Kochs E. · Förstl H.
Departments of aPsychiatry and Psychotherapy, bOrthopedics, and cAnesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: 4/29/2008
Published online: 6/24/2008

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM

Abstract

Background/Aims: The aim of the study was to investigate the association of postoperative delirium with the outcomes of cognitive impairment, functional disability and death. Methods: Hip surgery patients aged 60 years or over (n = 200) underwent preoperative and daily postoperative assessment of their cognitive status during hospital stay. Outcome variables were determined at an average of 8 and 38 months after discharge from hospital. Results: Fourty-one patients developed postoperative delirium. Delirium was a strong independent predictor of cognitive impairment and the occurrence of severe dependency in activities of daily living. The associations were more marked for the long- than for the short-term outcome. Thirty-eight months after discharge from hospital, 53.8% of the surviving patients with postoperative delirium suffered from cognitive impairment, as compared to only 4.4% of the nondelirious participants. Logistic regression analysis adjusted for age, sex, medical comorbidity and preoperative cognitive performance revealed highly significant associations between delirium and cognitive impairment (OR = 41.2; 95% CI = 4.3–396.2), subjective memory decline (OR = 6.2; 95% CI = 1.5–25.8) and incident need for long-term care (OR = 5.6; 95% CI = 1.6–19.7). Conclusion: The present study confirms a poor prognosis after delirium in elderly patients. The findings suggest that delirium does not simply persist for a certain time but also predicts a future cognitive decline with an increased risk of dementia.


  

Author Contacts

Prof. Dr. Hans Förstl
Klinikum rechts der Isar
Klinik und Poliklinik für Psychiatrie und Psychotherapie
Ismaninger Strasse 22, DE–81675 München
Tel. +49 89 4140 4200, Fax +49 89 4140 4837, E-Mail hans.foerstl@lrz.tu-muenchen.de

  

Article Information

Accepted: April 29, 2008
Published online: June 24, 2008
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 39

  

Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 26, No. 1, Year 2008 (Cover Date: July 2008)

Journal Editor: Chan-Palay V. (New York, N.Y.)
ISSN: 1420–8008 (Print), eISSN: 1421–9824 (Online)

For additional information: http://www.karger.com/DEM


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: 4/29/2008
Published online: 6/24/2008

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


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