ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2024
Structural disconnectivity in postoperative delirium: A perioperative two-center cohort study in older patients.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 9 citations in OpenAlex.
- Postoperative Delirium After Coronary Artery Bypass Grafting in the United States, 2016-2021: Trends, Risk Factors, and Outcomes.Journal of cardiothoracic and vascular anesthesia · 2026Observational
- Brain Microstructural Alteration and Its Implications for Postoperative Delirium in Elderly Surgical Patients: A Narrative Review.Brain and behavior · 2025Review
- Perioperative neurocognitive disorders: a comprehensive review of terminology, clinical implications, and future research directions.Frontiers in neurology · 2025Review
- Structural disconnectivity in postoperative delirium: A perioperative two-center cohort study in older patients.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
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Authors and funding
16 authors at 8 institutions in 5 countries.
Funding
Abstract
backgroundStructural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD).
methodsWe recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily.
resultsOf 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21-0.32] p < 0.001) was higher in patients with POD. Preoperative global MK (-0.07 [95% CI -0.11 to (-0.04)] p < 0.001) and FA (0.07 [95% CI -0.10 to (-0.04)] p < 0.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI -0.08 to (-0.03)] p < 0.001; n = 183) and higher after 12 months (0.28 [95% CI 0.20-0.35] p < 0.001; n = 45) among patients with POD. DISCUSSION: Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.
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