Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study
Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular sur...
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| Veröffentlicht in: | The American journal of surgery 2025-01, Vol.239, p.115784, Article 115784 |
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| container_title | The American journal of surgery |
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| creator | Goodijk, Dagmar Banning, Louise B.D. Te Velde-Keyzer, Charlotte A. van Munster, Barbara C. Bakker, Stephan J.L. van Leeuwen, Barbara L. Zeebregts, Clark J. Pol, Robert A. |
| description | Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.
A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.
Among 110 patients (18.2 % female, mean age 73.8 ± 5.7 years), cognitive impairment was evident in 48.2 %. Of the participants, 29 (26.3 %) experienced postoperative complications, among which 11 (10 %) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 % CI 1.02–1.38; p = 0.02).
Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.
•Approximately 50 % of vascular surgery patients exhibit cognitive impairment.•Worse preoperative cognitive performance was associated with increased odds of postoperative complications and delirium among vascular surgery patients.•Postoperative cognitive decline was significantly linked to lower baseline educational levels and a history of cerebrovascular disease.•More focus is needed on strategies to minimize complications in individuals with preexisting cognitive impairment. |
| doi_str_mv | 10.1016/j.amjsurg.2024.115784 |
| format | Article |
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A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.
Among 110 patients (18.2 % female, mean age 73.8 ± 5.7 years), cognitive impairment was evident in 48.2 %. Of the participants, 29 (26.3 %) experienced postoperative complications, among which 11 (10 %) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 % CI 1.02–1.38; p = 0.02).
Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.
•Approximately 50 % of vascular surgery patients exhibit cognitive impairment.•Worse preoperative cognitive performance was associated with increased odds of postoperative complications and delirium among vascular surgery patients.•Postoperative cognitive decline was significantly linked to lower baseline educational levels and a history of cerebrovascular disease.•More focus is needed on strategies to minimize complications in individuals with preexisting cognitive impairment.</description><identifier>ISSN: 0002-9610</identifier><identifier>ISSN: 1879-1883</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2024.115784</identifier><identifier>PMID: 38824053</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic aneurysms ; Body mass index ; Cerebrovascular disease ; Cognition ; Cognitive ability ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - etiology ; Cognitive impairment ; Comorbidity ; Complications ; Confounding (Statistics) ; Consent ; Delirium ; Delirium - epidemiology ; Delirium - etiology ; Female ; Hospitals ; Human subjects ; Humans ; Hypertension ; Impairment ; Male ; Medical research ; Mental disorders ; Mortality ; Patients ; Performance evaluation ; Population ; Postoperative ; Postoperative complications ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - psychology ; Preoperative Period ; Prospective Studies ; Regression analysis ; Risk Factors ; Statistical significance ; Surgery ; Variables ; Vascular surgery ; Vascular surgical procedure ; Vascular Surgical Procedures - adverse effects</subject><ispartof>The American journal of surgery, 2025-01, Vol.239, p.115784, Article 115784</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><rights>2024. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-7a1581e3f39f651256fb28b8b1f7f9419c6d21f82970db84ec38bddcf90bf9373</cites><orcidid>0000-0003-3356-6791 ; 0000-0002-8197-8056 ; 0000-0002-2236-5233 ; 0009-0004-0223-1053</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S000296102400312X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38824053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goodijk, Dagmar</creatorcontrib><creatorcontrib>Banning, Louise B.D.</creatorcontrib><creatorcontrib>Te Velde-Keyzer, Charlotte A.</creatorcontrib><creatorcontrib>van Munster, Barbara C.</creatorcontrib><creatorcontrib>Bakker, Stephan J.L.</creatorcontrib><creatorcontrib>van Leeuwen, Barbara L.</creatorcontrib><creatorcontrib>Zeebregts, Clark J.</creatorcontrib><creatorcontrib>Pol, Robert A.</creatorcontrib><title>Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.
A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.
Among 110 patients (18.2 % female, mean age 73.8 ± 5.7 years), cognitive impairment was evident in 48.2 %. Of the participants, 29 (26.3 %) experienced postoperative complications, among which 11 (10 %) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 % CI 1.02–1.38; p = 0.02).
Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.
•Approximately 50 % of vascular surgery patients exhibit cognitive impairment.•Worse preoperative cognitive performance was associated with increased odds of postoperative complications and delirium among vascular surgery patients.•Postoperative cognitive decline was significantly linked to lower baseline educational levels and a history of cerebrovascular disease.•More focus is needed on strategies to minimize complications in individuals with preexisting cognitive impairment.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic aneurysms</subject><subject>Body mass index</subject><subject>Cerebrovascular disease</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - epidemiology</subject><subject>Cognitive Dysfunction - etiology</subject><subject>Cognitive impairment</subject><subject>Comorbidity</subject><subject>Complications</subject><subject>Confounding (Statistics)</subject><subject>Consent</subject><subject>Delirium</subject><subject>Delirium - epidemiology</subject><subject>Delirium - etiology</subject><subject>Female</subject><subject>Hospitals</subject><subject>Human subjects</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Impairment</subject><subject>Male</subject><subject>Medical research</subject><subject>Mental disorders</subject><subject>Mortality</subject><subject>Patients</subject><subject>Performance evaluation</subject><subject>Population</subject><subject>Postoperative</subject><subject>Postoperative complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - psychology</subject><subject>Preoperative Period</subject><subject>Prospective Studies</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Statistical significance</subject><subject>Surgery</subject><subject>Variables</subject><subject>Vascular surgery</subject><subject>Vascular surgical procedure</subject><subject>Vascular Surgical Procedures - adverse effects</subject><issn>0002-9610</issn><issn>1879-1883</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcuO1DAQRS0EYpqBTwBZYsMmjcvOw2GDRiMYkEaCBawtx4_BURIHV9Kj_gT-GvdjEGLDyo86t1y-l5CXwLbAoH7bb_XY45rutpzxcgtQNbJ8RDYgm7YAKcVjsmGM8aKtgV2QZ4h9PgKU4im5EFLyklViQ359TS7OLukl7Bw18W4Kx12-8jGNejKO6snSsCDViNGETMaJ3oflB50jLn-Lx3kI5lhHGia602jWQSd6GNOlPZ1zzU0LvqNXdE4RZ2eOSlxWu39Onng9oHtxXi_J948fvl1_Km6_3Hy-vrotDG9gKRoNlQQnvGh9XQGvat9x2ckOfOPbElpTWw5e8rZhtpOlM0J21hrfss63ohGX5M2pb57g5-pwUWNA44ZBTy6uqASrRVnLEiCjr_9B-7imKU-nRDZSclm3PFPViTL5S5icV3MKo057BUwdslK9OmelDlmpU1ZZ9-rcfe1GZ_-oHsLJwPsT4LIdu-CSQpP9M86GlJ1TNob_PPEbr1Grog</recordid><startdate>202501</startdate><enddate>202501</enddate><creator>Goodijk, Dagmar</creator><creator>Banning, Louise B.D.</creator><creator>Te Velde-Keyzer, Charlotte A.</creator><creator>van Munster, Barbara C.</creator><creator>Bakker, Stephan J.L.</creator><creator>van Leeuwen, Barbara L.</creator><creator>Zeebregts, Clark J.</creator><creator>Pol, Robert A.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3356-6791</orcidid><orcidid>https://orcid.org/0000-0002-8197-8056</orcidid><orcidid>https://orcid.org/0000-0002-2236-5233</orcidid><orcidid>https://orcid.org/0009-0004-0223-1053</orcidid></search><sort><creationdate>202501</creationdate><title>Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study</title><author>Goodijk, Dagmar ; Banning, Louise B.D. ; Te Velde-Keyzer, Charlotte A. ; van Munster, Barbara C. ; Bakker, Stephan J.L. ; van Leeuwen, Barbara L. ; Zeebregts, Clark J. ; Pol, Robert A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-7a1581e3f39f651256fb28b8b1f7f9419c6d21f82970db84ec38bddcf90bf9373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic aneurysms</topic><topic>Body mass index</topic><topic>Cerebrovascular disease</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction - epidemiology</topic><topic>Cognitive Dysfunction - etiology</topic><topic>Cognitive impairment</topic><topic>Comorbidity</topic><topic>Complications</topic><topic>Confounding (Statistics)</topic><topic>Consent</topic><topic>Delirium</topic><topic>Delirium - epidemiology</topic><topic>Delirium - etiology</topic><topic>Female</topic><topic>Hospitals</topic><topic>Human subjects</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Impairment</topic><topic>Male</topic><topic>Medical research</topic><topic>Mental disorders</topic><topic>Mortality</topic><topic>Patients</topic><topic>Performance evaluation</topic><topic>Population</topic><topic>Postoperative</topic><topic>Postoperative complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - psychology</topic><topic>Preoperative Period</topic><topic>Prospective Studies</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Statistical significance</topic><topic>Surgery</topic><topic>Variables</topic><topic>Vascular surgery</topic><topic>Vascular surgical procedure</topic><topic>Vascular Surgical Procedures - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goodijk, Dagmar</creatorcontrib><creatorcontrib>Banning, Louise B.D.</creatorcontrib><creatorcontrib>Te Velde-Keyzer, Charlotte A.</creatorcontrib><creatorcontrib>van Munster, Barbara C.</creatorcontrib><creatorcontrib>Bakker, Stephan J.L.</creatorcontrib><creatorcontrib>van Leeuwen, Barbara L.</creatorcontrib><creatorcontrib>Zeebregts, Clark J.</creatorcontrib><creatorcontrib>Pol, Robert A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goodijk, Dagmar</au><au>Banning, Louise B.D.</au><au>Te Velde-Keyzer, Charlotte A.</au><au>van Munster, Barbara C.</au><au>Bakker, Stephan J.L.</au><au>van Leeuwen, Barbara L.</au><au>Zeebregts, Clark J.</au><au>Pol, Robert A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2025-01</date><risdate>2025</risdate><volume>239</volume><spage>115784</spage><pages>115784-</pages><artnum>115784</artnum><issn>0002-9610</issn><issn>1879-1883</issn><eissn>1879-1883</eissn><abstract>Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.
A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.
Among 110 patients (18.2 % female, mean age 73.8 ± 5.7 years), cognitive impairment was evident in 48.2 %. Of the participants, 29 (26.3 %) experienced postoperative complications, among which 11 (10 %) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 % CI 1.02–1.38; p = 0.02).
Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.
•Approximately 50 % of vascular surgery patients exhibit cognitive impairment.•Worse preoperative cognitive performance was associated with increased odds of postoperative complications and delirium among vascular surgery patients.•Postoperative cognitive decline was significantly linked to lower baseline educational levels and a history of cerebrovascular disease.•More focus is needed on strategies to minimize complications in individuals with preexisting cognitive impairment.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38824053</pmid><doi>10.1016/j.amjsurg.2024.115784</doi><orcidid>https://orcid.org/0000-0003-3356-6791</orcidid><orcidid>https://orcid.org/0000-0002-8197-8056</orcidid><orcidid>https://orcid.org/0000-0002-2236-5233</orcidid><orcidid>https://orcid.org/0009-0004-0223-1053</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aortic aneurysms Body mass index Cerebrovascular disease Cognition Cognitive ability Cognitive Dysfunction - epidemiology Cognitive Dysfunction - etiology Cognitive impairment Comorbidity Complications Confounding (Statistics) Consent Delirium Delirium - epidemiology Delirium - etiology Female Hospitals Human subjects Humans Hypertension Impairment Male Medical research Mental disorders Mortality Patients Performance evaluation Population Postoperative Postoperative complications Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - psychology Preoperative Period Prospective Studies Regression analysis Risk Factors Statistical significance Surgery Variables Vascular surgery Vascular surgical procedure Vascular Surgical Procedures - adverse effects |
| title | Preoperative cognitive performance and its association with postoperative complications in vascular surgery patients: A prospective study |
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