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Measures of executive function and depression identify patients at risk for postoperative delirium.

Publication ,  Journal Article
Greene, NH; Attix, DK; Weldon, BC; Smith, PJ; McDonagh, DL; Monk, TG
Published in: Anesthesiology
April 2009

BACKGROUND: Postoperative delirium is associated with increased morbidity and mortality. Preexisting cognitive impairment and depression have been frequently cited as important risk factors for this complication. This prospective cohort study was designed to determine whether individuals who perform poorly on preoperative cognitive tests and/or exhibited depressive symptoms would be at high risk for the development of postoperative delirium. METHODS: One hundred nondemented patients, aged 50 yr and older, scheduled to undergo major, elective noncardiac surgery completed a preoperative test battery that included measures of global cognition, executive function, and symptoms of depression. Known preoperative risk factors for delirium were collected and examined with the results of the preoperative test battery to determine the independent predictors of delirium. RESULTS: The overall incidence of delirium was 16% and was associated with increased hospital duration of stay (P < 0.05) and an increased incidence of postoperative complications (P < 0.01). Delirious subjects did not differ from their nondelirious cohorts with regard to their preoperative global cognitive function, preexisting medical comorbidities, age, anesthetic management, or history of alcohol use. Preoperative executive scores (P < 0.001) and depression (P < 0.001), as measured by the Trail Making B test and Geriatric Depression Scale-Short Form, respectively, were found to be independent predictors of postoperative delirium. CONCLUSIONS: Low preoperative executive scores and depressive symptoms independently predict postoperative delirium in older individuals. A rapid, simple test combination including tests of executive function and depression could improve physicians' ability to recognize patients who might benefit from a perioperative intervention strategy to prevent postoperative delirium.

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Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

April 2009

Volume

110

Issue

4

Start / End Page

788 / 795

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Prospective Studies
  • Preoperative Care
  • Predictive Value of Tests
  • Postoperative Complications
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Incidence
 

Citation

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Greene, N. H., Attix, D. K., Weldon, B. C., Smith, P. J., McDonagh, D. L., & Monk, T. G. (2009). Measures of executive function and depression identify patients at risk for postoperative delirium. Anesthesiology, 110(4), 788–795. https://doi.org/10.1097/aln.0b013e31819b5ba6
Greene, Nathaniel H., Deborah K. Attix, B Craig Weldon, Patrick J. Smith, David L. McDonagh, and Terri G. Monk. “Measures of executive function and depression identify patients at risk for postoperative delirium.Anesthesiology 110, no. 4 (April 2009): 788–95. https://doi.org/10.1097/aln.0b013e31819b5ba6.
Greene NH, Attix DK, Weldon BC, Smith PJ, McDonagh DL, Monk TG. Measures of executive function and depression identify patients at risk for postoperative delirium. Anesthesiology. 2009 Apr;110(4):788–95.
Greene, Nathaniel H., et al. “Measures of executive function and depression identify patients at risk for postoperative delirium.Anesthesiology, vol. 110, no. 4, Apr. 2009, pp. 788–95. Pubmed, doi:10.1097/aln.0b013e31819b5ba6.
Greene NH, Attix DK, Weldon BC, Smith PJ, McDonagh DL, Monk TG. Measures of executive function and depression identify patients at risk for postoperative delirium. Anesthesiology. 2009 Apr;110(4):788–795.

Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

April 2009

Volume

110

Issue

4

Start / End Page

788 / 795

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk Factors
  • Prospective Studies
  • Preoperative Care
  • Predictive Value of Tests
  • Postoperative Complications
  • Neuropsychological Tests
  • Middle Aged
  • Male
  • Incidence