Structural disconnectivity in postoperative delirium: A perioperative two-center cohort study in older patients

BioCog Consortium, Marinus Fislage, Stefan Winzeck, Rebecca Woodrow, Florian Lammers-Lietz, Emmanuel A Stamatakis, Marta M Correia, Jacobus Preller, Insa Feinkohl, Jeroen Hendrikse, Tobias Pischon, Claudia D Spies, Arjen J C Slooter, Georg Winterer, David K Menon, Norman Zacharias

Onderzoeksoutput: Articlepeer review


BACKGROUND: Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD).

METHODS: We recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily.

RESULTS: Of 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21-0.32] p < 0.001) was higher in patients with POD. Preoperative global MK (-0.07 [95% CI -0.11 to (-0.04)] p < 0.001) and FA (0.07 [95% CI -0.10 to (-0.04)] p < 0.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI -0.08 to (-0.03)] p < 0.001; n = 183) and higher after 12 months (0.28 [95% CI 0.20-0.35] p < 0.001; n = 45) among patients with POD.

DISCUSSION: Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.

Originele taal-2English
Pagina's (van-tot)2861-2872
Aantal pagina's12
TijdschriftAlzheimer's & Dementia
Nummer van het tijdschrift4
Vroegere onlinedatum7 mrt 2024
StatusPublished - apr 2024

Bibliografische nota

© 2024 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.


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