Related Experiment Video
Updated: Feb 10, 2026
Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Cognitive Decline after Delirium in Patients Undergoing Cardiac Surgery
Charles H Brown1, Julia Probert, Ryan Healy
1From the Department of Anesthesiology and Critical Care Medicine (C.H.B., R.H., M.P.) Department of Surgery (Y.N., K.Z., K.M.) Department of Psychiatry and Behavioral Sciences (V.K., K.J.N.) Johns Hopkins University School of Medicine, Baltimore, Maryland; New York University School of Medicine, New York, New York (J.P.) Department of Cardiovascular Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan (A.Y.) Biostatistics Consulting Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.T.) Department of Anesthesiology and Critical Care Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois (C.W.H.).
Insights
Postoperative delirium after cardiac surgery is linked to significant cognitive decline at one month, particularly in visuoconstruction and processing speed. However, this cognitive impact is not sustained at one year, except for processing speed.
Area of Science:
- Neuroscience
- Cardiology
- Gerontology
Background:
- Cardiac surgery is frequently associated with cognitive decline and postoperative delirium.
- The precise relationship between delirium and long-term cognitive impairment post-cardiac surgery remains incompletely understood, with conflicting reports on its trajectory and affected cognitive domains.
Purpose of the Study:
- To investigate the association between postoperative delirium and cognitive decline at one month and one year following cardiac surgery.
- To determine if delirium predicts cognitive decline in specific domains after cardiac surgery.
Main Methods:
- A cohort study included 142 patients undergoing coronary artery bypass and/or valve surgery with cardiopulmonary bypass.
- Delirium was assessed using the Confusion Assessment Method, with neuropsychological testing conducted pre-surgery, at one month, and one year post-surgery.
- Linear regression analyzed the association between delirium and changes in cognitive function.
Main Results:
- The incidence of delirium was 53.5%.
- Patients with delirium showed a significant decline in composite cognitive Z score at one month (-0.29; P=0.020), specifically in visuoconstruction and processing speed.
- At one year, no significant difference in composite cognitive score was observed between delirious and non-delirious patients, though processing speed decline persisted in the delirium group.
Conclusions:
- Postoperative delirium after cardiac surgery is associated with greater short-term cognitive decline, affecting visuoconstruction and processing speed.
- The cognitive deficits observed at one month post-delirium do not significantly persist at one year, with the exception of processing speed decline.
What We Already Know About This Topic:
Cardiac surgery is associated with cognitive decline and postoperative delirium. The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear
What This Article Tells Us That Is New:
The development of postoperative delirium is associated with a greater degree of cognitive decline 1 month after cardiac surgery. The development of postoperative delirium is not a predictor of cognitive decline 1 yr after cardiac surgery.
Background:
Delirium is common after cardiac surgery and has been associated with morbidity, mortality, and cognitive decline. However, there are conflicting reports on the magnitude, trajectory, and domains of cognitive change that might be affected. The authors hypothesized that patients with delirium would experience greater cognitive decline at 1 month and 1 yr after cardiac surgery compared to those without delirium.
Methods:
Patients who underwent coronary artery bypass and/or valve surgery with cardiopulmonary bypass were eligible for this cohort study. Delirium was assessed with the Confusion Assessment Method. A neuropsychologic battery was administered before surgery, at 1 month, and at 1 yr later. Linear regression was used to examine the association between delirium and change in composite cognitive Z score from baseline to 1 month (primary outcome). Secondary outcomes were domain-specific changes at 1 month and composite and domain-specific changes at 1 yr.
Results:
The incidence of delirium in 142 patients was 53.5%. Patients with delirium had greater decline in composite cognitive Z score at 1 month (greater decline by -0.29; 95% CI, -0.54 to -0.05; P = 0.020) and in the domains of visuoconstruction and processing speed. From baseline to 1 yr, there was no difference between delirious and nondelirious patients with respect to change in composite cognitive Z score, although greater decline in processing speed persisted among the delirious patients.
Conclusions:
Patients who developed delirium had greater decline in a composite measure of cognition and in visuoconstruction and processing speed domains at 1 month. The differences in cognitive change by delirium were not significant at 1 yr, with the exception of processing speed.
More Related Videos
08:17A Mouse Model of Orthopedic Surgery to Study Postoperative Cognitive Dysfunction and Tissue Regeneration
Published on: February 27, 2018
07:14A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery
Published on: January 18, 2018
Related Concept Videos
01:19Magnetic Declination
02:07Conservation of Declining Populations
01:38Cognitive Dissonance
01:27Language and Cognition
01:25Cognitive Therapy
01:23Cognition and Behavior