The effects of elective aortic repair, colorectal cancer surgery and subsequent postoperative delirium on long-term quality of life, cognitive functioning and depressive symptoms in older patients
Janssen,Ties L de Vries,Jolanda Lodder,Paul Faes,Miriam C Ho,Gwan H Gobardhan,Paul D van der Laan,Lijckle
Janssen,Ties L
de Vries,Jolanda
Lodder,Paul
Faes,Miriam C
Ho,Gwan H
Gobardhan,Paul D
van der Laan,Lijckle
Abstract
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.
Description
Funding Information: The PhD program of the corresponding author (T. L. Janssen) is funded by an ‘unrestricted grant’ by Amphia Fund for innovation. All other authors declare that they have no competing interests.
Date
2021
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Research Projects
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Keywords
ANEURYSMS, DEMENTIA, DISTRESS, ELDERLY-PATIENTS, MORTALITY, OUTCOMES, RECALL, RISK, SYMPTOMATOLOGY, cognitive functioning, elective surgery, older patients, postoperative delirium, quality of life, SDG 3 - Good Health and Well-being
Citation
Janssen, T L, de Vries, J, Lodder, P, Faes, M C, Ho, G H, Gobardhan, P D & van der Laan, L 2021, 'The effects of elective aortic repair, colorectal cancer surgery and subsequent postoperative delirium on long-term quality of life, cognitive functioning and depressive symptoms in older patients', Aging & Mental Health, vol. 25, no. 5, pp. 896-905. https://doi.org/10.1080/13607863.2020.1725807