Postoperative delirium was associated with significantly worse psychological (p=0.001), social (p=0.006), and environmental (p=0.001) quality of life at 12 months.
Cohort (n=265)
No
Does postoperative delirium worsen quality of life, cognitive functioning, and depressive symptoms in older patients undergoing elective major abdominal surgery?
Postoperative delirium in older patients undergoing major abdominal surgery is associated with long-term decreases in psychological, social, and environmental quality of life, as well as increased depressive symptoms.
p-value: p=0.001, 0.006, 0.001
Objectives: This study aimed to demonstrate the impact of elective major abdominal surgery and subsequent postoperative delirium on quality of life (QOL; primary outcome), cognitive functioning and depressive symptoms (secondary outcomes) in older surgical patients.Method: A single-centre, longitudinal prospective cohort study was conducted between November 2015 and June 2018, including patients ≥70 years old who underwent surgery for colorectal cancer or an abdominal aortic aneurysm. They were followed-up at discharge and at 6 and 12 months postoperatively until June 2019. QOL was assessed with the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Cognitive functioning was measured with the Mini-Mental State Examination and depressive symptoms with the CES-D 16.Results: In all patients (n = 265), physical and psychological health were significantly lower at discharge compared to baseline (p < 0.001 for both domains). Physical health restored after 6 months, but psychological health remained decreased for the complete study period. Psychological, social and environmental QOL were significantly worse in patients with delirium compared to patients without (p = 0.001, p = 0.006 and p = 0.001 respectively). The cognitive functioning score was significantly lower at baseline in patients with delirium compared to those without (p = 0.006). Patients with delirium had a significantly higher CES-D 16 score compared to those without after 12 months (p = 0.027).Conclusion: Physical and psychological QOL were decreased in the early postoperative period. While physical health was restored after 6 and 12 months, psychological health remained decreased. After 12 months, postoperative delirium resulted in worse psychological, social and environmental QOL and more depressive symptoms. Decreased cognitive functioning may be a risk factor for delirium.
Janssen et al. (Thu,) conducted a cohort in colorectal cancer or abdominal aortic aneurysm (n=265). postoperative delirium vs. no postoperative delirium was evaluated on quality of life (QOL) (p=0.001, 0.006, 0.001). Postoperative delirium was associated with significantly worse psychological (p=0.001), social (p=0.006), and environmental (p=0.001) quality of life at 12 months.