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Tytuł:
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Association of preoperative vitamin D deficiency with the risk of postoperative delirium and cognitive dysfunction: A meta-analysis.
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Autorzy:
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Hung KC; Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan.
Wang LK; Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan.
Lin YT; Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan; Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan.
Yu CH; Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan.
Chang CY; Department of Neurology, Chi Mei Medical Center, Tainan City 71004, Taiwan; Center for General Education, Southern Taiwan University of Science and Technology, Tainan 71004, Taiwan.
Sun CK; Department of Emergency Medicine, E-Da Hospital, Kaohsiung City 82445, Taiwan; College of Medicine, I-Shou University, Kaohsiung City 82445, Taiwan.
Chen JY; Department of Anesthesiology, Chi Mei Medical Center, Tainan City 71004, Taiwan. Electronic address: .
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Źródło:
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Journal of clinical anesthesia [J Clin Anesth] 2022 Aug; Vol. 79, pp. 110681. Date of Electronic Publication: 2022 Mar 04.
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Typ publikacji:
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Journal Article; Meta-Analysis; Review
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Język:
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English
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Imprint Name(s):
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Publication: <2008->: New York : Elsevier
Original Publication: [Stoneham, MA] : Butterworths, [c1988-
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MeSH Terms:
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Cognitive Dysfunction*/epidemiology
Cognitive Dysfunction*/etiology
Delirium*/epidemiology
Hypertension*/complications
Vitamin D Deficiency*/complications
Vitamin D Deficiency*/epidemiology
Humans ; Male ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology
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Contributed Indexing:
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Keywords: Postoperative cognitive dysfunction; Postoperative delirium; Risk factors; Surgery; Vitamin D deficiency
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Entry Date(s):
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Date Created: 20220307 Date Completed: 20220504 Latest Revision: 20220525
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Update Code:
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20240104
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DOI:
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10.1016/j.jclinane.2022.110681
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PMID:
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35255352
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Study Objective: Despite vitamin D deficiency (VDD) associated with cognitive dysfunction in the general population, the impacts of preoperative VDD on postoperative delirium (POD) and cognitive dysfunction (POCD) remain to be clarified.
Design: Meta-analysis of cohort studies.
Setting: Postoperative care.
Intervention: Preoperative VDD as the prognostic factor.
Patients: Adult patients undergoing surgery.
Measurements: Databases including MEDLINE, EMBASE, Google scholar, and the Cochrane Library databases were searched from inception to September 2021. Random-effects modeling was applied to the pooling of results on the association between preoperative VDD and POD/POCD. The primary outcome was the association of VDD with the risk of POD/POCD, while the secondary outcomes included other prognostic factors (e.g., hypertension) with the risk of POD/POCD. A prediction interval (PI) was calculated to indicate the range of a true effect size of a future study in 95% of all populations.
Main Results: Meta-analysis of seven observational studies involving 2673 patients showed that the pooled incidence of POD/POCD was 29% (95% confidence interval (CI): 18% to 44%). Our results demonstrated that preoperative VDD increased the risk of POD/POCD [odds ratio (OR) = 1.54, 95% CI: 1.21-1.97, p < 0.01; I 2 = 29.2%, seven studies, 2673 patients; 95% PI: 0.89-2.67], while vitamin D insufficiency was not associated with a higher risk of POD/POCD (OR = 0.88, 95% CI: 0.49-1.57, p = 0.66; I 2 = 62.6%, four studies, 1410 patients; 95% PI: 0.09-8.79). The PI in our primary outcome (i.e., 0.89 to 2.67) containing 1.0 suggested the possibility of inconsistent results in future studies. Patients with POD/POCD were older compared to those without. Hypertension, diabetes mellitus, male gender, or smoking was not recognized as risk factors for POD/POCD.
Conclusions: Our results demonstrated that preoperative vitamin D deficiency was associated with postoperative cognitive impairment. Given the prediction interval, more future studies are needed to elucidate associations between VDD and POD/POCD.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
