Trajectory of severity of postoperative delirium symptoms and its prospective association with cognitive function in patients with gastric cancer

results from a prospective observational study

Eun Jung Shim, Hae Lim Noh, Kwang Min Lee, Heesung Hwang, Kyung Lak Son, Dooyoung Jung, Won Hyoung Kim, Seong Ho Kong, Yun Suhk Suh, Hyuk-Joon Lee, Han-Kwang Yang, Bong-Jin Hahm

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: Delirium is a common neurocognitive complication in cancer. Despite this, the studies examining the trajectory of the severity of delirium symptoms and its impact on health outcome in gastric cancer is rather limited. This study examined the trajectory of delirium symptom severity (DSS) following resection surgery for gastric cancer and its prospective association with cognitive function. Methods: A three-wave prospective observational study was conducted with 242 gastric cancer patients admitted for resection surgery at a teaching hospital in South Korea from May 2016 to November 2017. DSS was assessed by the clinical staff before and 1, 2, 3, and 7 days after surgery using the Delirium Rating Scale-Revised-98. A survey including the Functional Assessment of Cancer Therapy-Cognitive Scale (FACT-Cog) and Mini-Mental State Examination (MMSE) was administered before surgery (T0), 7 days after (T1), and 3 to 6 months after surgery (T2). Results: Out of 242 participants, 48.8% (118) completed the survey at all three time points, 43.4% (105) did so for two time points, and 7.9% (19) for one time point. No cases of full delirium were observed over four postoperative time points. Latent growth curve modeling analyses indicated that DSS declined over 3 days after surgery. Age and anesthesia time were positively associated with the initial level of DSS. A medication history for memory complaints was related to a slower recovery from delirium symptoms. While the use of propofol as an anesthetic agent was associated with lower initial DSS, it predicted a slower recovery from DSS. A higher initial DSS predicted a lower T1 MMSE score. Conclusions: Severity of postoperative delirium symptoms predicts a short-term and objective cognitive function post-surgery. Monitoring and timely treatment of postoperative delirium symptoms is needed to diminish cognitive consequences in gastric cancer patients.

Original languageEnglish
Pages (from-to)2999-3006
Number of pages8
JournalSupportive Care in Cancer
Volume27
Issue number8
DOIs
StatePublished - 1 Aug 2019

Fingerprint

Delirium
Cognition
Stomach Neoplasms
Observational Studies
Prospective Studies
Republic of Korea
Cognitive Therapy
Propofol
Teaching Hospitals
Anesthetics
Neoplasms

Keywords

  • Anesthesia
  • Cognitive function
  • Delirium
  • Gastrectomy
  • Gastric cancer

Cite this

@article{ddeb6beb3a474511b6e60ea54b42d3d9,
title = "Trajectory of severity of postoperative delirium symptoms and its prospective association with cognitive function in patients with gastric cancer: results from a prospective observational study",
abstract = "Purpose: Delirium is a common neurocognitive complication in cancer. Despite this, the studies examining the trajectory of the severity of delirium symptoms and its impact on health outcome in gastric cancer is rather limited. This study examined the trajectory of delirium symptom severity (DSS) following resection surgery for gastric cancer and its prospective association with cognitive function. Methods: A three-wave prospective observational study was conducted with 242 gastric cancer patients admitted for resection surgery at a teaching hospital in South Korea from May 2016 to November 2017. DSS was assessed by the clinical staff before and 1, 2, 3, and 7 days after surgery using the Delirium Rating Scale-Revised-98. A survey including the Functional Assessment of Cancer Therapy-Cognitive Scale (FACT-Cog) and Mini-Mental State Examination (MMSE) was administered before surgery (T0), 7 days after (T1), and 3 to 6 months after surgery (T2). Results: Out of 242 participants, 48.8{\%} (118) completed the survey at all three time points, 43.4{\%} (105) did so for two time points, and 7.9{\%} (19) for one time point. No cases of full delirium were observed over four postoperative time points. Latent growth curve modeling analyses indicated that DSS declined over 3 days after surgery. Age and anesthesia time were positively associated with the initial level of DSS. A medication history for memory complaints was related to a slower recovery from delirium symptoms. While the use of propofol as an anesthetic agent was associated with lower initial DSS, it predicted a slower recovery from DSS. A higher initial DSS predicted a lower T1 MMSE score. Conclusions: Severity of postoperative delirium symptoms predicts a short-term and objective cognitive function post-surgery. Monitoring and timely treatment of postoperative delirium symptoms is needed to diminish cognitive consequences in gastric cancer patients.",
keywords = "Anesthesia, Cognitive function, Delirium, Gastrectomy, Gastric cancer",
author = "Shim, {Eun Jung} and Noh, {Hae Lim} and Lee, {Kwang Min} and Heesung Hwang and Son, {Kyung Lak} and Dooyoung Jung and Kim, {Won Hyoung} and Kong, {Seong Ho} and Suh, {Yun Suhk} and Hyuk-Joon Lee and Han-Kwang Yang and Bong-Jin Hahm",
year = "2019",
month = "8",
day = "1",
doi = "10.1007/s00520-018-4604-4",
language = "English",
volume = "27",
pages = "2999--3006",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "8",

}

Trajectory of severity of postoperative delirium symptoms and its prospective association with cognitive function in patients with gastric cancer : results from a prospective observational study. / Shim, Eun Jung; Noh, Hae Lim; Lee, Kwang Min; Hwang, Heesung; Son, Kyung Lak; Jung, Dooyoung; Kim, Won Hyoung; Kong, Seong Ho; Suh, Yun Suhk; Lee, Hyuk-Joon; Yang, Han-Kwang; Hahm, Bong-Jin.

In: Supportive Care in Cancer, Vol. 27, No. 8, 01.08.2019, p. 2999-3006.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Trajectory of severity of postoperative delirium symptoms and its prospective association with cognitive function in patients with gastric cancer

T2 - results from a prospective observational study

AU - Shim, Eun Jung

AU - Noh, Hae Lim

AU - Lee, Kwang Min

AU - Hwang, Heesung

AU - Son, Kyung Lak

AU - Jung, Dooyoung

AU - Kim, Won Hyoung

AU - Kong, Seong Ho

AU - Suh, Yun Suhk

AU - Lee, Hyuk-Joon

AU - Yang, Han-Kwang

AU - Hahm, Bong-Jin

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose: Delirium is a common neurocognitive complication in cancer. Despite this, the studies examining the trajectory of the severity of delirium symptoms and its impact on health outcome in gastric cancer is rather limited. This study examined the trajectory of delirium symptom severity (DSS) following resection surgery for gastric cancer and its prospective association with cognitive function. Methods: A three-wave prospective observational study was conducted with 242 gastric cancer patients admitted for resection surgery at a teaching hospital in South Korea from May 2016 to November 2017. DSS was assessed by the clinical staff before and 1, 2, 3, and 7 days after surgery using the Delirium Rating Scale-Revised-98. A survey including the Functional Assessment of Cancer Therapy-Cognitive Scale (FACT-Cog) and Mini-Mental State Examination (MMSE) was administered before surgery (T0), 7 days after (T1), and 3 to 6 months after surgery (T2). Results: Out of 242 participants, 48.8% (118) completed the survey at all three time points, 43.4% (105) did so for two time points, and 7.9% (19) for one time point. No cases of full delirium were observed over four postoperative time points. Latent growth curve modeling analyses indicated that DSS declined over 3 days after surgery. Age and anesthesia time were positively associated with the initial level of DSS. A medication history for memory complaints was related to a slower recovery from delirium symptoms. While the use of propofol as an anesthetic agent was associated with lower initial DSS, it predicted a slower recovery from DSS. A higher initial DSS predicted a lower T1 MMSE score. Conclusions: Severity of postoperative delirium symptoms predicts a short-term and objective cognitive function post-surgery. Monitoring and timely treatment of postoperative delirium symptoms is needed to diminish cognitive consequences in gastric cancer patients.

AB - Purpose: Delirium is a common neurocognitive complication in cancer. Despite this, the studies examining the trajectory of the severity of delirium symptoms and its impact on health outcome in gastric cancer is rather limited. This study examined the trajectory of delirium symptom severity (DSS) following resection surgery for gastric cancer and its prospective association with cognitive function. Methods: A three-wave prospective observational study was conducted with 242 gastric cancer patients admitted for resection surgery at a teaching hospital in South Korea from May 2016 to November 2017. DSS was assessed by the clinical staff before and 1, 2, 3, and 7 days after surgery using the Delirium Rating Scale-Revised-98. A survey including the Functional Assessment of Cancer Therapy-Cognitive Scale (FACT-Cog) and Mini-Mental State Examination (MMSE) was administered before surgery (T0), 7 days after (T1), and 3 to 6 months after surgery (T2). Results: Out of 242 participants, 48.8% (118) completed the survey at all three time points, 43.4% (105) did so for two time points, and 7.9% (19) for one time point. No cases of full delirium were observed over four postoperative time points. Latent growth curve modeling analyses indicated that DSS declined over 3 days after surgery. Age and anesthesia time were positively associated with the initial level of DSS. A medication history for memory complaints was related to a slower recovery from delirium symptoms. While the use of propofol as an anesthetic agent was associated with lower initial DSS, it predicted a slower recovery from DSS. A higher initial DSS predicted a lower T1 MMSE score. Conclusions: Severity of postoperative delirium symptoms predicts a short-term and objective cognitive function post-surgery. Monitoring and timely treatment of postoperative delirium symptoms is needed to diminish cognitive consequences in gastric cancer patients.

KW - Anesthesia

KW - Cognitive function

KW - Delirium

KW - Gastrectomy

KW - Gastric cancer

UR - http://www.scopus.com/inward/record.url?scp=85059629476&partnerID=8YFLogxK

U2 - 10.1007/s00520-018-4604-4

DO - 10.1007/s00520-018-4604-4

M3 - Article

VL - 27

SP - 2999

EP - 3006

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 8

ER -