Trial reportDementia and geriatric cognitive disorders2014
Do stress markers and anesthetic technique predict delirium in the elderly?
Trial report in Dementia and geriatric cognitive disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Role of Peripheral Inflammation in Delirium.Brain and behavior · 2025Pooled it
- Subjective cognitive complaints in patients undergoing major non-cardiac surgery: a prospective single centre cohort trial.British journal of anaesthesia · 2019Trial
- Randomised, masked study of local anaesthesia administered prior to external dacryocystorhinostomy under general anaesthesia.Eye (London, England) · 2019Trial
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Preoperative Risk Factors Associated with Increased Incidence of Postoperative Delirium: Systematic Review of Qualified Clinical Studies.Geriatrics (Basel, Switzerland) · 2023Review
- Treatment of Delirium During Critical Illness.Annual review of medicine · 2022Review
- Delirium.Nature reviews. Disease primers · 2020Review
- Relationship Between Serum Norepinephrine Levels at ICU Admission and the Risk of ICU-Acquired Delirium: Secondary Analysis of the Melatonin Evaluation of Lowered Inflammation of ICU Trial.Critical care explorations · 2020Article
- Cognitive Impairment Is Associated with Absolute Intraoperative Frontal α-Band Power but Not with Baseline α-Band Power: A Pilot Study.Dementia and geriatric cognitive disorders · 2019Observational
- An update on postoperative delirium: Clinical features, neuropathogenesis, and perioperative management.Current anesthesiology reports · 2018Article
- [Preoperative risk identification using the Identification of Seniors at Risk? : Suitability as sole screening tool for inpatient aged risk patients].Zeitschrift fur Gerontologie und Geriatrie · 2018Review
- Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara.Patient preference and adherence · 2017Article
- [Knowledge and implementation of the S3 guideline on delirium management in Germany].Der Anaesthesist · 2016Article
- Can Intraoperative Processed EEG Predict Postoperative Cognitive Dysfunction in the Elderly?Clinical therapeutics · 2015Article
- Postoperative Delirium in the Geriatric Patient.Anesthesiology clinics · 2015Review
- The Elderly Spine Surgery Patient: Pre- and Intraoperative Management of Drug Therapy.Drugs & aging · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundPostoperative delirium (PD) is a prevalent complication of elderly surgical patients, which predisposes to worsened cognitive recovery and dementia. Risk of PD has been associated with increasing magnitude of the hypothalamic-pituitary-adrenal stress response (serum cortisol, epinephrine and norepinephrine) to surgery. Anesthetics suppress this response; however, some (total intravenous anesthesia, TIVA) more than others (anesthetic gases). Prior comparisons of anesthetics have been equivocal but have not included stress markers. We hypothesized that TIVA would decrease serum stress markers and the incidence of PD.
methodsWe performed a prospective cohort study of 76 elderly major surgical patients. Patients received TIVA or sevoflurane gas, and blood was drawn for serum markers pre-, intra-, and postoperatively. PD was assessed with the Confusion Assessment Method. We compared stress markers and PD between patients who received TIVA versus sevoflurane, and then modeled PD including stress and anesthetic.
resultsThe group that received TIVA during surgery demonstrated lower levels of all stress markers compared to the gas group, but no difference in PD. However, across groups, the postoperative norepinephrine level was much higher in patients who developed PD. Other markers and other times had no effect.
conclusionThe development of PD depends more on postoperative stress than intraoperative stress or anesthetic.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.