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Clinical outcomes in older surgical patients with mild cognitive impairment
Author(s) -
Racine Annie M.,
Fong Tamara G.,
Gou Yun,
Travison Thomas G.,
Tommet Douglas,
Erickson Kristen,
Jones Richard N.,
Dickerson Bradford C.,
Metzger Eran,
Marcantonio Edward R.,
Schmitt Eva M.,
Inouye Sharon K.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.10.010
Subject(s) - delirium , medicine , incidence (geometry) , relative risk , adverse effect , observational study , cohort study , cohort , cognitive impairment , prospective cohort study , complication , cognition , psychiatry , confidence interval , physics , optics
Older adults, including those with mild cognitive impairment (MCI), are increasingly undergoing surgery. Methods Relative risks (RRs) of MCI alone or with delirium on adverse outcomes were estimated in an ongoing prospective, observational cohort study of 560 nondemented adults aged ≥70 years. Results MCI (n = 61, 11%) was associated with increased RR of delirium (RR = 1.9, P < .001) and delirium severity (RR = 4.6, P < .001). Delirium alone (n = 107), but not MCI alone (n = 34), was associated with multiple adverse outcomes including more major postoperative complication(s) (RR = 2.5, P = .002) and longer length of stay (RR = 2.2, P < .001). Patients with concurrent MCI and delirium (n = 27) were more often discharged to a postacute facility (RR = 1.4, P < .001) and had synergistically increased risk for new impairments in cognitive functioning (RR = 3.6, P < .001). Discussion MCI is associated with increased risk of delirium incidence and severity. Patients with delirium and MCI have synergistically elevated risk of developing new difficulties in cognitively demanding tasks.