Sex Differences in Delirium after Coronary Artery Bypass Graft Surgery and Perioperative Neuropsychiatric Conditions: A Secondary Analysis of a Cohort Study

IF 2.9 4区 医学 Q2 CLINICAL NEUROLOGY Journal of Geriatric Psychiatry and Neurology Pub Date : 2024-04-12 DOI:10.1177/08919887241246226
Mark A. Oldham, Bennett Kukla, Patrick Walsh, Hochang B Lee
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Abstract

BackgroundBiological sex influences the risk of depression and cognitive impairment, but its role in relation to postoperative delirium is unclear. This analysis investigates sex differences in delirium risk after coronary artery bypass graft (CABG) surgery and sex-related differences in relation to affective and cognitive symptoms.MethodsThis is a secondary analysis of the Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study, a single-site, observational study of a CABG surgery cohort (n = 149). Preoperative characteristics are stratified by sex, and baseline variables that differ by sex are evaluated to understand whether sex modifies their relationships with delirium. We also evaluate sex differences in one-month depression and cognition.ResultsFemale sex is associated with several delirium risk factors, including higher risk of preoperative depression and middle cerebral artery (MCA) stenosis. MCA stenosis was statistically associated with delirium only among women (OR 15.6, 95% CI 1.5, 164.4); mild cognitive impairment (MCI) was associated with delirium only in men (OR 4.6, 95% CI 1.2, 17.9). Other sex-based differences failed to reach statistical significance. Depression remained commoner among women 1 month post-CABG.ConclusionsWomen in this CABG cohort were more likely to have depression at baseline and 1 month postoperatively, as well as MCA stenosis and postoperative delirium. Sex might modify the relationship between post-CABG delirium and its risk factors including MCA stenosis and MCI. Cerebrovascular disease deserves study as a potential explanation linking female sex and a range of poor outcomes among women with coronary heart disease.
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冠状动脉旁路移植手术后谵妄和围手术期神经精神疾病的性别差异:队列研究的二次分析
背景生理性别影响抑郁和认知障碍的风险,但其在术后谵妄中的作用尚不清楚。本分析调查了冠状动脉旁路移植术(CABG)术后谵妄风险的性别差异,以及与情感和认知症状相关的性别差异。方法这是心脏手术后神经精神结果(NOAHS)研究的二次分析,该研究是一项对CABG手术队列(n = 149)进行的单点观察性研究。我们按性别对术前特征进行了分层,并评估了因性别而异的基线变量,以了解性别是否会改变它们与谵妄的关系。我们还评估了一个月抑郁和认知方面的性别差异。结果女性性别与多个谵妄风险因素相关,包括术前抑郁和大脑中动脉(MCA)狭窄的风险较高。据统计,只有女性的大脑中动脉狭窄与谵妄有关(OR 15.6,95% CI 1.5,164.4);只有男性的轻度认知障碍(MCI)与谵妄有关(OR 4.6,95% CI 1.2,17.9)。其他性别差异未达到统计学意义。结论在这组 CABG 患者中,女性在基线和术后 1 个月更容易患抑郁症、MCA 狭窄和术后谵妄。性别可能会改变 CABG 术后谵妄与其风险因素(包括 MCA 狭窄和 MCI)之间的关系。脑血管疾病是女性性别与女性冠心病患者一系列不良预后之间的潜在联系,值得研究。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
40
审稿时长
>12 weeks
期刊介绍: Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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