Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub-analysis.
Acta Anaesthesiol Scand. 2018 Mar 26. doi: 10.1111/aas.13116
Zhang Y1, Shan GJ1, Zhang YX1, Cao SJ1, Zhu SN2, Li HJ3, Ma D4, Wang DX1.
- 1 Department of Anaesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
- 2 Department of Biostatics, Peking University First Hospital, Beijing, China.
- 3 Peking University Clinical Research Institute, Beijing, China.
- 4 Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Chelsea and Westminster Hospital, Imperial College London, London, UK.
- Delirium 2.7 X more likely after hip fracture and low vitamin D – May 2015
- Cognitive Impairment 2.4X more likely if low vitamin D – meta-analysis July 2012
Items in both categories Cognitive and Trauma-Surgery are listed here:
- Delirium or cognitive problems after surgery 1.5X more likely if low vitamin D –meta-analysis Aug 2022
- Cardiac Surgery with low vitamin D increased delirium 1.4X, mortality 1.5X – May 2020
- Delirium 24 percent more likely for each 2.5 ng lower vitamin D (313,000 patients) – Feb 2019
- Dementia risk increased 2.4 X following TBI, even if had not lost consciousness – May 2018
- 5 Traumatic brain injuries resulted in 2.8 X increased risk of dementia – April 2018
- Postoperative cognitive dysfunction 8 X more likely if low vitamin D – March 2018
- Delirium in Hospitalized Older Adults (does not mention low vitamin D relationship) NEJM Oct 2017
- Vitamin D and Glutamine reduced Trauma Center deaths by half – Matthews March 2017
- Football Brain injuries prevented by Omega-3 – RCT Jan 2016
- Delirium 2.7 X more likely after hip fracture and low vitamin D – May 2015
- Hospital induced delirium 2X more likely if low vitamin D – April 2015
- Magnesium may be an important way to treat brain trauma
- Vitamin D aided progesterone in reducing traumatic brain injury – RCT Dec 2012
Trauma and surgery category starts with the following
- You can easily improve outcomes of many planned surgeries by increasing vitamin D ahead of time
- Cancer surgery is the only known exception - extra Vitamin D is OK only if doctor reduces the chemo doses
- A loading dose of Vitamin D also improves unplanned hospital admissions
- Improvements include
- Shorter recovery time
- Shorter ICU time
- Reduced deaths – in hospital, next month, next year
- Reduced Sepsis = blood poisoning = infection
Wikipedia
- "Postoperative cognitive dysfunction (POCD) is a decline in cognitive function (especially in memory and executive functions) that may last from a few days to a few weeks after surgery. In rare cases, this disorder may persist for several months after major surgery"
- "POCD is common after cardiac surgery, and recent studies have now verified that POCD also exists after major non-cardiac surgery, although at a lower incidence. The risk of POCD increases with age, and the type of surgery is also important because there is a very low incidence associated with minor surgery.[3] POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive problems."
BACKGROUND:
Vitamin D is important for maintaining physiological functions including cognition and its deficiency is associated with the occurrence of cognitive impairment. This study was to explore the association between preoperative vitamin D status and the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing major surgery.
METHODS:
This was a predefined exploratory sub-analysis of one-centre data from a randomized controlled trial. In all, 123 elderly (≥ 65 years) patients who were scheduled to undergo major cancer surgery were recruited. Serum 25-hydroxyvitamin D concentration was measured before surgery. In total, 59 nonsurgical control subjects with comparable age and education level were also enrolled. A battery of neuropsychological tests was administered the day before and the 7th day after surgery in patients or at the same time interval in control subjects. POCD was diagnosed according to the ISPOCD1 definition.
RESULTS:
71.5% (88/123) of elderly patients had vitamin D deficiency (serum 25-hydroxyvitamin D concentration < 12 ng/ml) before surgery; 24.4% (30/123) of them developed cognitive dysfunction at 1 week after surgery. After adjusting for confounding factors, high preoperative serum 25-hydroxyvitamine D concentration was related to a decreased risk of POCD (odds ratio [OR]: 0.829, 95% confidence interval [CI]: 0.708-0.971; P = 0.020), whereas preoperative vitamin D deficiency was associated with an increased risk of POCD (OR: 8.427, 95% CI: 1.595-44.511; P = 0.012).
CONCLUSIONS:
Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.
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