Observational studyBMC psychology2019
Type D personality is a predictor of prolonged acute brain dysfunction (delirium/coma) after cardiovascular surgery.
Observational study in BMC psychology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Psychological factors associated with postoperative cognitive outcomes in older adults: a systematic review and meta-analysis.British journal of anaesthesia · 2026Pooled it
- Depression as a predictor of postoperative delirium after cardiac surgery: a systematic review and meta-analysis.Interactive cardiovascular and thoracic surgery · 2021Pooled it
- Delirium severity does not differ between medical and surgical intensive care units after adjusting for medication use.Scientific reports · 2022Trial
- Delirium Severity Trajectories and Outcomes in ICU Patients. Defining a Dynamic Symptom Phenotype.Annals of the American Thoracic Society · 2020Trial
- Type A and Type D Personality in Cardiovascular Health: A Narrative Review.Healthcare (Basel, Switzerland) · 2026Review
- Delirium after cardiac surgery incidence and perioperative risk factors in a prospective cohort.Journal of cardiothoracic surgery · 2026Article
- Association between type D personality and supportive care needs in elderly patients with breast cancer: a prospective longitudinal observational study.BMC geriatrics · 2023Observational
- Pediatric delirium is associated with increased brain injury marker levels in cardiac surgery patients.Scientific reports · 2022Article
- Incidence and interaction factors of delirium as an independent risk of mortality in elderly patients in the intensive units: a retrospective analysis from MIMIC-IV database.Aging clinical and experimental research · 2022Article
- Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review.International journal of environmental research and public health · 2022Review
- Type D personality and self-esteem in patients with fibromyalgia: a cross-sectional case-control study.Rheumatology international · 2022Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have shown a relationship between delirium and depressive symptoms after cardiac surgery with distress personalities linking to negative surgical outcomes. The aim of the present study is to further investigate the association between patients with Type D (distressed) personality with regards to delirium after cardiac surgery.
methodsWe conducted a consecutive-sample observational cohort pilot study with an estimated 142 patients needed. Enrollment criteria included patients aged ≥18 years who were undergoing planned cardiovascular, thoracic and abdominal artery surgery between October 2015 to August 2016 at the University of Tsukuba Hospital, Japan. All patients were screened by Type-D Personality Scale-14 (DS14) as well as the Hospital Anxiety and Depression Scale (HADS) the day before surgery. Following surgery, daily data was collected during recovery and included severity of organ dysfunction, sedative/analgesic exposure and other relevant information. We then evaluated the association between Type D personality and delirium/coma days (DCDs) during the 7-day study period. We applied regression and mediation modeling for this study.
resultsA total of 142 patients were enrolled in the present study and the total prevalence of delirium was found to be 34% and 26% of the patients were Type D. Non-Type D personality patients experienced an average of 1.3 DCDs during the week after surgery while Type D patients experienced 2.1 days over the week after surgery. Multivariate analysis showed that Type D personality was significantly associated with increased DCDs (OR:2.8, 95%CI:1.3-6.1) after adjustment for depressive symptoms and clinical variables. Additionally, there was a significant Type D x depression interaction effect (OR:1.7, 95% CI:1.2-2.2), and depressive symptoms were associated with DCDs in Type D patients, but not in non-Type D patients. Mediation modeling showed that depressive symptoms partially mediated the association of Type D personality with DCDs (Aroian test =0.04).
conclusionsType D personality is a prognostic predictor for prolonged acute brain dysfunction (delirium/coma) in cardiovascular patients independent from depressive symptoms and Type D personality-associated depressive symptoms increase the magnitude of acute brain dysfunction.
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