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Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub‐analysis
Author(s) -
Zhang Y.,
Shan G.J.,
Zhang Y.X.,
Cao S.J.,
Zhu S.N.,
Li H.J.,
Ma D.,
Wang D.X.
Publication year - 2018
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13116
Subject(s) - medicine , postoperative cognitive dysfunction , odds ratio , confidence interval , confounding , vitamin d and neurology , vitamin d deficiency , randomized controlled trial , surgery , cognition , anesthesia , psychiatry
Background Vitamin D is important for maintaining physiological functions including cognition and its deficiency is associated with the occurrence of cognitive impairment. This study was to explore the association between preoperative vitamin D status and the occurrence of postoperative cognitive dysfunction ( POCD ) in elderly patients undergoing major surgery. Methods This was a predefined exploratory sub‐analysis of one‐centre data from a randomized controlled trial. In all, 123 elderly (≥ 65 years) patients who were scheduled to undergo major cancer surgery were recruited. Serum 25‐hydroxyvitamin D concentration was measured before surgery. In total, 59 nonsurgical control subjects with comparable age and education level were also enrolled. A battery of neuropsychological tests was administered the day before and the 7th day after surgery in patients or at the same time interval in control subjects. POCD was diagnosed according to the ISPOCD 1 definition. Results 71.5% (88/123) of elderly patients had vitamin D deficiency (serum 25‐hydroxyvitamin D concentration < 12 ng/ml) before surgery; 24.4% (30/123) of them developed cognitive dysfunction at 1 week after surgery. After adjusting for confounding factors, high preoperative serum 25‐hydroxyvitamine D concentration was related to a decreased risk of POCD (odds ratio [ OR ]: 0.829, 95% confidence interval [ CI ]: 0.708–0.971; P = 0.020), whereas preoperative vitamin D deficiency was associated with an increased risk of POCD ( OR : 8.427, 95% CI : 1.595–44.511; P = 0.012). Conclusions Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.