Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial
Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium. To determine whether preoperative cognitive training reduces the i...
Gespeichert in:
| Veröffentlicht in: | JAMA network open 2024-04, Vol.7 (4), p.e247361 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | |
|---|---|
| container_issue | 4 |
| container_start_page | e247361 |
| container_title | JAMA network open |
| container_volume | 7 |
| creator | Jiang, Yu Xie, Yanhu Fang, Panpan Shang, Zixiang Chen, Lihai Zhou, Jifang Yang, Chao Zhu, Wenjie Hao, Xixi Ding, Jianming Yin, Panpan Wang, Zan Cao, Mengyuan Zhang, Yu Tan, Qilian Cheng, Dan Kong, Siyu Lu, Xianfu Liu, Xuesheng Sessler, Daniel I |
| description | Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium.
To determine whether preoperative cognitive training reduces the incidence of delirium in patients undergoing coronary artery bypass grafting.
This prospective, single-blind, randomized clinical trial was conducted at 3 university teaching hospitals in southeastern China with enrollment between April 2022 and May 2023. Eligible participants included those scheduled for elective coronary artery bypass grafting who consented and enrolled at least 10 days before surgery.
Participating patients were randomly assigned 1:1, stratified by site, to either routine care or cognitive training, which included substantial practice with online tasks designed to enhance cognitive functions including memory, imagination, reasoning, reaction time, attention, and processing speed.
The primary outcome was occurrence of delirium during postoperative days 1 to 7 or until hospital discharge, diagnosed using the Confusion Assessment Method or the Confusion Assessment Method for Intensive Care Units. Secondary outcomes were postoperative cognitive dysfunction, delirium characteristics, and all-cause mortality within 30 days following the operation.
A total of 218 patients were randomized and 208 (median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male [69.2%]) were included in final analysis, with 102 randomized to cognitive training and 106 randomized to routine care. Of all participants, 95 (45.7%) had only a primary school education and 54 (26.0%) had finished high school. In the cognitive training group, 28 participants (27.5%) developed delirium compared with 46 participants (43.4%) randomized to routine care. Those receiving cognitive training were 57% less likely to develop delirium compared with those receiving routine care (adjusted odds ratio [aOR] 0.43; 95% CI, 0.23-0.77; P = .007). Significant differences were observed in the incidence of severe delirium (aOR, 0.46; 95% CI, 0.25-0.82; P = .01), median (IQR) duration of delirium (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .008), and median (IQR) number of delirium-positive days (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .007). No other secondary outcomes differed significantly.
In this randomized trial of 208 patient |
| doi_str_mv | 10.1001/jamanetworkopen.2024.7361 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11040409</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3141378335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c345t-41f0d878b61dc295e6040d83f152680bd53e7d6e51707a494629859784b555193</originalsourceid><addsrcrecordid>eNpdkU9P3DAQxS3UChDlK1SueullFzu2Y4dLhQIUJCQQhbPljSepl8Te2gkIPn0d8UeUky3Pe29m_EPoGyVLSgg9WJvBeBgfQrwLG_DLghR8KVlJt9BuISRfMEXEp3f3HbSf0poQUhDKqlJsox2mSlFwqXbRpg6dd6O7B3wTjfPOd7gNEV-DnZrRBY9Di4-hd9FNA3YeX5nRgR8TvvUWYhdmQ22idabBv6fYQXw8xEf42ngbBvcEFtd9jm1Mnxs4039Bn1vTJ9h_OffQ7enJTX22uLj8dV4fXSwaxsW44LQlVkm1KqltikpASXh-YC0VRanIygoG0pYgqCTS8IqXRaVEJRVfCSFoxfbQz-fczbQawDZ55mh6vYluMPFRB-P0_xXv_ugu3GtKcydO5oQfLwkx_J0gjXpwqYG-z98fpqQZ4YJSxbjK0u8fpOswRZ_304xyyqRiTGRV9axqYkgpQvs2DSV6Zqs_sNUzWz2zzd6v79d5c76SZP8AIcSk4Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3141378335</pqid></control><display><type>article</type><title>Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Jiang, Yu ; Xie, Yanhu ; Fang, Panpan ; Shang, Zixiang ; Chen, Lihai ; Zhou, Jifang ; Yang, Chao ; Zhu, Wenjie ; Hao, Xixi ; Ding, Jianming ; Yin, Panpan ; Wang, Zan ; Cao, Mengyuan ; Zhang, Yu ; Tan, Qilian ; Cheng, Dan ; Kong, Siyu ; Lu, Xianfu ; Liu, Xuesheng ; Sessler, Daniel I</creator><creatorcontrib>Jiang, Yu ; Xie, Yanhu ; Fang, Panpan ; Shang, Zixiang ; Chen, Lihai ; Zhou, Jifang ; Yang, Chao ; Zhu, Wenjie ; Hao, Xixi ; Ding, Jianming ; Yin, Panpan ; Wang, Zan ; Cao, Mengyuan ; Zhang, Yu ; Tan, Qilian ; Cheng, Dan ; Kong, Siyu ; Lu, Xianfu ; Liu, Xuesheng ; Sessler, Daniel I ; CT-LIFE Study Collaborators</creatorcontrib><description>Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium.
To determine whether preoperative cognitive training reduces the incidence of delirium in patients undergoing coronary artery bypass grafting.
This prospective, single-blind, randomized clinical trial was conducted at 3 university teaching hospitals in southeastern China with enrollment between April 2022 and May 2023. Eligible participants included those scheduled for elective coronary artery bypass grafting who consented and enrolled at least 10 days before surgery.
Participating patients were randomly assigned 1:1, stratified by site, to either routine care or cognitive training, which included substantial practice with online tasks designed to enhance cognitive functions including memory, imagination, reasoning, reaction time, attention, and processing speed.
The primary outcome was occurrence of delirium during postoperative days 1 to 7 or until hospital discharge, diagnosed using the Confusion Assessment Method or the Confusion Assessment Method for Intensive Care Units. Secondary outcomes were postoperative cognitive dysfunction, delirium characteristics, and all-cause mortality within 30 days following the operation.
A total of 218 patients were randomized and 208 (median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male [69.2%]) were included in final analysis, with 102 randomized to cognitive training and 106 randomized to routine care. Of all participants, 95 (45.7%) had only a primary school education and 54 (26.0%) had finished high school. In the cognitive training group, 28 participants (27.5%) developed delirium compared with 46 participants (43.4%) randomized to routine care. Those receiving cognitive training were 57% less likely to develop delirium compared with those receiving routine care (adjusted odds ratio [aOR] 0.43; 95% CI, 0.23-0.77; P = .007). Significant differences were observed in the incidence of severe delirium (aOR, 0.46; 95% CI, 0.25-0.82; P = .01), median (IQR) duration of delirium (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .008), and median (IQR) number of delirium-positive days (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .007). No other secondary outcomes differed significantly.
In this randomized trial of 208 patients undergoing coronary artery bypass grafting, preoperative cognitive training reduced the incidence of postoperative delirium. However, our primary analysis was based on fewer than 75 events and should therefore be considered exploratory and a basis for future larger trials.
Chinese Clinical Trial Registry Identifier: ChiCTR2200058243.</description><identifier>ISSN: 2574-3805</identifier><identifier>EISSN: 2574-3805</identifier><identifier>DOI: 10.1001/jamanetworkopen.2024.7361</identifier><identifier>PMID: 38652478</identifier><language>eng</language><publisher>United States: American Medical Association</publisher><subject>Aged ; Anesthesiology ; China - epidemiology ; Clinical trials ; Cognitive Behavioral Therapy - methods ; Cognitive Training ; Coronary Artery Bypass - adverse effects ; Coronary vessels ; Delirium ; Delirium - epidemiology ; Delirium - etiology ; Delirium - prevention & control ; Female ; Heart surgery ; Humans ; Male ; Middle Aged ; Online Only ; Original Investigation ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; Prospective Studies ; Single-Blind Method</subject><ispartof>JAMA network open, 2024-04, Vol.7 (4), p.e247361</ispartof><rights>2024. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright 2024 Jiang Y et al. .</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c345t-41f0d878b61dc295e6040d83f152680bd53e7d6e51707a494629859784b555193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38652478$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiang, Yu</creatorcontrib><creatorcontrib>Xie, Yanhu</creatorcontrib><creatorcontrib>Fang, Panpan</creatorcontrib><creatorcontrib>Shang, Zixiang</creatorcontrib><creatorcontrib>Chen, Lihai</creatorcontrib><creatorcontrib>Zhou, Jifang</creatorcontrib><creatorcontrib>Yang, Chao</creatorcontrib><creatorcontrib>Zhu, Wenjie</creatorcontrib><creatorcontrib>Hao, Xixi</creatorcontrib><creatorcontrib>Ding, Jianming</creatorcontrib><creatorcontrib>Yin, Panpan</creatorcontrib><creatorcontrib>Wang, Zan</creatorcontrib><creatorcontrib>Cao, Mengyuan</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Tan, Qilian</creatorcontrib><creatorcontrib>Cheng, Dan</creatorcontrib><creatorcontrib>Kong, Siyu</creatorcontrib><creatorcontrib>Lu, Xianfu</creatorcontrib><creatorcontrib>Liu, Xuesheng</creatorcontrib><creatorcontrib>Sessler, Daniel I</creatorcontrib><creatorcontrib>CT-LIFE Study Collaborators</creatorcontrib><title>Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial</title><title>JAMA network open</title><addtitle>JAMA Netw Open</addtitle><description>Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium.
To determine whether preoperative cognitive training reduces the incidence of delirium in patients undergoing coronary artery bypass grafting.
This prospective, single-blind, randomized clinical trial was conducted at 3 university teaching hospitals in southeastern China with enrollment between April 2022 and May 2023. Eligible participants included those scheduled for elective coronary artery bypass grafting who consented and enrolled at least 10 days before surgery.
Participating patients were randomly assigned 1:1, stratified by site, to either routine care or cognitive training, which included substantial practice with online tasks designed to enhance cognitive functions including memory, imagination, reasoning, reaction time, attention, and processing speed.
The primary outcome was occurrence of delirium during postoperative days 1 to 7 or until hospital discharge, diagnosed using the Confusion Assessment Method or the Confusion Assessment Method for Intensive Care Units. Secondary outcomes were postoperative cognitive dysfunction, delirium characteristics, and all-cause mortality within 30 days following the operation.
A total of 218 patients were randomized and 208 (median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male [69.2%]) were included in final analysis, with 102 randomized to cognitive training and 106 randomized to routine care. Of all participants, 95 (45.7%) had only a primary school education and 54 (26.0%) had finished high school. In the cognitive training group, 28 participants (27.5%) developed delirium compared with 46 participants (43.4%) randomized to routine care. Those receiving cognitive training were 57% less likely to develop delirium compared with those receiving routine care (adjusted odds ratio [aOR] 0.43; 95% CI, 0.23-0.77; P = .007). Significant differences were observed in the incidence of severe delirium (aOR, 0.46; 95% CI, 0.25-0.82; P = .01), median (IQR) duration of delirium (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .008), and median (IQR) number of delirium-positive days (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .007). No other secondary outcomes differed significantly.
In this randomized trial of 208 patients undergoing coronary artery bypass grafting, preoperative cognitive training reduced the incidence of postoperative delirium. However, our primary analysis was based on fewer than 75 events and should therefore be considered exploratory and a basis for future larger trials.
Chinese Clinical Trial Registry Identifier: ChiCTR2200058243.</description><subject>Aged</subject><subject>Anesthesiology</subject><subject>China - epidemiology</subject><subject>Clinical trials</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive Training</subject><subject>Coronary Artery Bypass - adverse effects</subject><subject>Coronary vessels</subject><subject>Delirium</subject><subject>Delirium - epidemiology</subject><subject>Delirium - etiology</subject><subject>Delirium - prevention & control</subject><subject>Female</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Online Only</subject><subject>Original Investigation</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prospective Studies</subject><subject>Single-Blind Method</subject><issn>2574-3805</issn><issn>2574-3805</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9P3DAQxS3UChDlK1SueullFzu2Y4dLhQIUJCQQhbPljSepl8Te2gkIPn0d8UeUky3Pe29m_EPoGyVLSgg9WJvBeBgfQrwLG_DLghR8KVlJt9BuISRfMEXEp3f3HbSf0poQUhDKqlJsox2mSlFwqXbRpg6dd6O7B3wTjfPOd7gNEV-DnZrRBY9Di4-hd9FNA3YeX5nRgR8TvvUWYhdmQ22idabBv6fYQXw8xEf42ngbBvcEFtd9jm1Mnxs4039Bn1vTJ9h_OffQ7enJTX22uLj8dV4fXSwaxsW44LQlVkm1KqltikpASXh-YC0VRanIygoG0pYgqCTS8IqXRaVEJRVfCSFoxfbQz-fczbQawDZ55mh6vYluMPFRB-P0_xXv_ugu3GtKcydO5oQfLwkx_J0gjXpwqYG-z98fpqQZ4YJSxbjK0u8fpOswRZ_304xyyqRiTGRV9axqYkgpQvs2DSV6Zqs_sNUzWz2zzd6v79d5c76SZP8AIcSk4Q</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Jiang, Yu</creator><creator>Xie, Yanhu</creator><creator>Fang, Panpan</creator><creator>Shang, Zixiang</creator><creator>Chen, Lihai</creator><creator>Zhou, Jifang</creator><creator>Yang, Chao</creator><creator>Zhu, Wenjie</creator><creator>Hao, Xixi</creator><creator>Ding, Jianming</creator><creator>Yin, Panpan</creator><creator>Wang, Zan</creator><creator>Cao, Mengyuan</creator><creator>Zhang, Yu</creator><creator>Tan, Qilian</creator><creator>Cheng, Dan</creator><creator>Kong, Siyu</creator><creator>Lu, Xianfu</creator><creator>Liu, Xuesheng</creator><creator>Sessler, Daniel I</creator><general>American Medical Association</general><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>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240401</creationdate><title>Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial</title><author>Jiang, Yu ; Xie, Yanhu ; Fang, Panpan ; Shang, Zixiang ; Chen, Lihai ; Zhou, Jifang ; Yang, Chao ; Zhu, Wenjie ; Hao, Xixi ; Ding, Jianming ; Yin, Panpan ; Wang, Zan ; Cao, Mengyuan ; Zhang, Yu ; Tan, Qilian ; Cheng, Dan ; Kong, Siyu ; Lu, Xianfu ; Liu, Xuesheng ; Sessler, Daniel I</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c345t-41f0d878b61dc295e6040d83f152680bd53e7d6e51707a494629859784b555193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Anesthesiology</topic><topic>China - epidemiology</topic><topic>Clinical trials</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Cognitive Training</topic><topic>Coronary Artery Bypass - adverse effects</topic><topic>Coronary vessels</topic><topic>Delirium</topic><topic>Delirium - epidemiology</topic><topic>Delirium - etiology</topic><topic>Delirium - prevention & control</topic><topic>Female</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Online Only</topic><topic>Original Investigation</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prospective Studies</topic><topic>Single-Blind Method</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiang, Yu</creatorcontrib><creatorcontrib>Xie, Yanhu</creatorcontrib><creatorcontrib>Fang, Panpan</creatorcontrib><creatorcontrib>Shang, Zixiang</creatorcontrib><creatorcontrib>Chen, Lihai</creatorcontrib><creatorcontrib>Zhou, Jifang</creatorcontrib><creatorcontrib>Yang, Chao</creatorcontrib><creatorcontrib>Zhu, Wenjie</creatorcontrib><creatorcontrib>Hao, Xixi</creatorcontrib><creatorcontrib>Ding, Jianming</creatorcontrib><creatorcontrib>Yin, Panpan</creatorcontrib><creatorcontrib>Wang, Zan</creatorcontrib><creatorcontrib>Cao, Mengyuan</creatorcontrib><creatorcontrib>Zhang, Yu</creatorcontrib><creatorcontrib>Tan, Qilian</creatorcontrib><creatorcontrib>Cheng, Dan</creatorcontrib><creatorcontrib>Kong, Siyu</creatorcontrib><creatorcontrib>Lu, Xianfu</creatorcontrib><creatorcontrib>Liu, Xuesheng</creatorcontrib><creatorcontrib>Sessler, Daniel I</creatorcontrib><creatorcontrib>CT-LIFE Study Collaborators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JAMA network open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiang, Yu</au><au>Xie, Yanhu</au><au>Fang, Panpan</au><au>Shang, Zixiang</au><au>Chen, Lihai</au><au>Zhou, Jifang</au><au>Yang, Chao</au><au>Zhu, Wenjie</au><au>Hao, Xixi</au><au>Ding, Jianming</au><au>Yin, Panpan</au><au>Wang, Zan</au><au>Cao, Mengyuan</au><au>Zhang, Yu</au><au>Tan, Qilian</au><au>Cheng, Dan</au><au>Kong, Siyu</au><au>Lu, Xianfu</au><au>Liu, Xuesheng</au><au>Sessler, Daniel I</au><aucorp>CT-LIFE Study Collaborators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial</atitle><jtitle>JAMA network open</jtitle><addtitle>JAMA Netw Open</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>7</volume><issue>4</issue><spage>e247361</spage><pages>e247361-</pages><issn>2574-3805</issn><eissn>2574-3805</eissn><abstract>Postoperative delirium is a common and impactful neuropsychiatric complication in patients undergoing coronary artery bypass grafting surgery. Cognitive training may enhance cognitive reserve, thereby reducing postoperative delirium.
To determine whether preoperative cognitive training reduces the incidence of delirium in patients undergoing coronary artery bypass grafting.
This prospective, single-blind, randomized clinical trial was conducted at 3 university teaching hospitals in southeastern China with enrollment between April 2022 and May 2023. Eligible participants included those scheduled for elective coronary artery bypass grafting who consented and enrolled at least 10 days before surgery.
Participating patients were randomly assigned 1:1, stratified by site, to either routine care or cognitive training, which included substantial practice with online tasks designed to enhance cognitive functions including memory, imagination, reasoning, reaction time, attention, and processing speed.
The primary outcome was occurrence of delirium during postoperative days 1 to 7 or until hospital discharge, diagnosed using the Confusion Assessment Method or the Confusion Assessment Method for Intensive Care Units. Secondary outcomes were postoperative cognitive dysfunction, delirium characteristics, and all-cause mortality within 30 days following the operation.
A total of 218 patients were randomized and 208 (median [IQR] age, 66 [58-70] years; 64 female [30.8%] and 144 male [69.2%]) were included in final analysis, with 102 randomized to cognitive training and 106 randomized to routine care. Of all participants, 95 (45.7%) had only a primary school education and 54 (26.0%) had finished high school. In the cognitive training group, 28 participants (27.5%) developed delirium compared with 46 participants (43.4%) randomized to routine care. Those receiving cognitive training were 57% less likely to develop delirium compared with those receiving routine care (adjusted odds ratio [aOR] 0.43; 95% CI, 0.23-0.77; P = .007). Significant differences were observed in the incidence of severe delirium (aOR, 0.46; 95% CI, 0.25-0.82; P = .01), median (IQR) duration of delirium (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .008), and median (IQR) number of delirium-positive days (0 [0-1] days for cognitive training vs 0 [0-2] days for routine care; P = .007). No other secondary outcomes differed significantly.
In this randomized trial of 208 patients undergoing coronary artery bypass grafting, preoperative cognitive training reduced the incidence of postoperative delirium. However, our primary analysis was based on fewer than 75 events and should therefore be considered exploratory and a basis for future larger trials.
Chinese Clinical Trial Registry Identifier: ChiCTR2200058243.</abstract><cop>United States</cop><pub>American Medical Association</pub><pmid>38652478</pmid><doi>10.1001/jamanetworkopen.2024.7361</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2574-3805 |
| ispartof | JAMA network open, 2024-04, Vol.7 (4), p.e247361 |
| issn | 2574-3805 2574-3805 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11040409 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Aged Anesthesiology China - epidemiology Clinical trials Cognitive Behavioral Therapy - methods Cognitive Training Coronary Artery Bypass - adverse effects Coronary vessels Delirium Delirium - epidemiology Delirium - etiology Delirium - prevention & control Female Heart surgery Humans Male Middle Aged Online Only Original Investigation Postoperative Complications - epidemiology Postoperative Complications - prevention & control Prospective Studies Single-Blind Method |
| title | Cognitive Training for Reduction of Delirium in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T04%3A00%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cognitive%20Training%20for%20Reduction%20of%20Delirium%20in%20Patients%20Undergoing%20Cardiac%20Surgery:%20A%20Randomized%20Clinical%20Trial&rft.jtitle=JAMA%20network%20open&rft.au=Jiang,%20Yu&rft.aucorp=CT-LIFE%20Study%20Collaborators&rft.date=2024-04-01&rft.volume=7&rft.issue=4&rft.spage=e247361&rft.pages=e247361-&rft.issn=2574-3805&rft.eissn=2574-3805&rft_id=info:doi/10.1001/jamanetworkopen.2024.7361&rft_dat=%3Cproquest_pubme%3E3141378335%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3141378335&rft_id=info:pmid/38652478&rfr_iscdi=true |