title: No convincing association between post-operative delirium and post-operative cognitive dysfunction: a secondary analysis.
abstract: BACKGROUND
  Post-operative delirium and post-operative cognitive dysfunction (POCD) are both common but it has not been clarified how closely they are associated. We aimed to assess the possible relationship in a secondary analysis of data from the 'Surgery Depth of anaesthesia and Cognitive outcome'- study.
  
  
  METHODS
  We included patients aged ≥ 60 years undergoing non-cardiac surgery planned for longer than 60 min. Delirium was assessed according to the Diagnostic and Statistical Manual of Mental Disorders IV criteria in the post-anaesthesia care unit (PACU) as well as within the first week after surgery. Cognitive function was assessed with a neuropsychological test battery. Multivariable analysis of POCD was performed with consideration of predisposing and precipitating factors.
  
  
  RESULTS
  Of 1277 randomized patients, 850 (66.6%) had complete data. Delirium was found in 270 patients (32.9% of 850). We detected POCD in 162 (20.9% of 776) at 1 week and in 52 (9.4% of 553) at 3 months. In multivariable analysis (n = 808), delirium had no overall effect on POCD (P = 0.30). Patients with no delirium in PACU but with postoperative delirium within 7 days had an increased risk of POCD at 3 months (OR = 2.56 (95%-confidence interval: 1.07-6.16), P = 0.035). No significant association was found for the other subgroups.
  
  
  CONCLUSIONS
  There is no clear evidence that postoperative delirium is independently associated with POCD up to 3 months.
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: M
authors: M
authors: Franck
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: K
authors: K
authors: Nerlich
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: B
authors: B
authors: Neuner
authors: Department of Medical Statistics, Informatics and Documentation, University Hospital Jena, Jena, Germany.
authors: P
authors: P
authors: Schlattmann
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: W R
authors: WR
authors: Brockhaus
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors: C D
authors: CD
authors: Spies
authors: Department of Anaesthesiology and Intensive Care Medicine, Campus-Virchow-Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany. fmr@regionsjaelland.dk.|Anaestesiafdelingen, Naestved Sygehus, Naestved, Denmark. fmr@regionsjaelland.dk.
authors: F M
authors: FM
authors: Radtke
mesh_terms: D000368:Aged; D060825:Cognitive Dysfunction / Q000209:etiology*; D003693:Delirium / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology*