Rudolph, JamesInouye, SharonJones, Richard N.Yang, Frances MargaretFong, TamaraLevkoff, SueMarcantonio, Edward2017-08-152010Rudolph, James L., Sharon K. Inouye, Richard N. Jones, Frances M. Yang, Tamara G. Fong, Sue E. Levkoff, and Edward R. Marcantonio. 2010. “Delirium: An Independent Predictor of Functional Decline After Cardiac Surgery.” Journal of the American Geriatrics Society 58 (4) (March 22): 643–649. doi:10.1111/j.1532-5415.2010.02762.x.0002-8614http://nrs.harvard.edu/urn-3:HUL.InstRepos:33750344OBJECTIVES: To determine whether patients who developed delirium after cardiac surgery were at risk of functional decline. DESIGN: Prospective cohort study. SETTING: Two academic hospitals and a Veterans Affairs Medical Center. PARTICIPANTS: One hundred ninety patients aged 60 and older undergoing elective or urgent cardiac surgery. MEASUREMENTS: Delirium was assessed daily and was diagnosed according to the Confusion Assessment Method. Before surgery and 1 and 12 months postoperatively, patients were assessed for function using the instrumental activities of daily living (IADL) scale. Functional decline was defined as a decrease in ability to perform one IADL at follow-up. RESULTS: Delirium occurred in 43.1% (n=82) of the patients (mean age 73.7±6.7). Functional decline occurred in 36.3% (n=65/179) at 1 month and in 14.6% (n=26/178) at 12 months. Delirium was associated with greater risk of functional decline at 1 month (relative risk (RR)=1.9, 95% confidence interval (CI)=1.3–2.8) and tended toward greater risk at 12 months (RR=1.9, 95% CI=0.9–3.8). After adjustment for age, cognition, comorbidity, and baseline function, delirium remained significantly associated with functional decline at 1 month (adjusted RR=1.8, 95% CI=1.2–2.6) but not at 12 months (adjusted RR=1.5, 95% CI=0.6–3.3). CONCLUSION: Delirium was independently associated with functional decline at 1 month and had a trend toward association at 12 months. These findings provide justification for intervention trials to evaluate whether delirium prevention or treatment strategies might improve postoperative functional recovery.en-USdeliriumfunctioncardiac surgeryagedinstrumental activities of daily livingJournal Article2014-12-20Rudolph JL, Inouye SK, Jones RN, Yang FM, Fong TG, Levkoff SE, Marcantonio ER2017-08-1510.1111/j.1532-5415.2010.02762.x