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| Item Type: | Article |
|---|---|
| Title: | Presurgical thalamus volume in postoperative delirium: a longitudinal observational cohort study in older patients |
| Creators Name: | Fislage, M., Feinkohl, I., Pischon, T., Spies, C.D., Borchers, F., Winterer, G. and Zacharias, N. |
| Abstract: | BACKGROUND: Previous studies suggest a role of the thalamus in cognitive function, while others implicate it as a central effect site of anesthetics. Yet, its role in postoperative neurocognition in the aging brain remains uncertain. We used presurgical thalamic volume as a functional indicator and determined its association with postoperative delirium (POD). METHODS: For this study, 301 older adults (aged ≥65) without dementia and scheduled for surgery were enrolled. Before surgery, participants underwent magnetic resonance imaging (MRI). Thalamus volume was segmented using Freesurfer (Version 5.3.). Participants were screened for POD twice a day until discharge or for a maximum of 7 days. POD was defined as a positive screening on ≥1 of 4 validated instruments: Richmond Agitation Sedation Scale (RASS), Nursing Delirium Screening Scale (Nu-DESC), Confusion Assessment Method (CAM), and Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) score. A logistic regression associated thalamus volume with POD with adjustment for age, global brain atrophy, and physical status according to the American Society of Anesthesiologists (ASA) classification. RESULTS: In this cohort, 44 participants (14.6%) were diagnosed with POD. Independently of age, global brain atrophy, and physical status score, a higher preoperative thalamus volume was associated with a reduced odds of POD (odds ratio per 1-cm3 increment; 0.73 [95% confidence interval (CI), 0.58-0.92]; P = .008). CONCLUSIONS: A larger thalamus volume was associated with reduced odds of POD. Thus, the thalamus marks a region of interest in POD in the aging brain. These findings may help to understand the neuronal basis of POD. |
| Keywords: | Atrophy, Cohort Studies, Delirium, Intensive Care Units, Postoperative Complications, Thalamus / Diagnostic Imaging |
| Source: | Anesthesia and Analgesia |
| ISSN: | 0003-2999 |
| Publisher: | International Anesthesia Research Society (IARS) |
| Volume: | 135 |
| Number: | 1 |
| Page Range: | 136-142 |
| Date: | July 2022 |
| Additional Information: | Copyright © 2022 International Anesthesia Research Society |
| Official Publication: | https://doi.org/10.1213/ane.0000000000005987 |
| PubMed: | View item in PubMed |
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