Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation.
Delirium, changes in cognitive function, and risk of diagnosed dementia after kidney transplantation.
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DOI：
10.1111/ajt.17176
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发表时间：
2022-12
期刊：
影响因子：
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中科院分区：
文献类型：
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Kidney transplant (KT) recipients with delirium, a preventable surgical complication, are likely to reap cognitive benefits from restored kidney function, but may be more vulnerable to longer-term neurotoxic stressors post-KT (i.e., aging, immunosuppression). In this prospective cohort study, we measured delirium (chart-based), global cognitive function (3MS), and executive function (Trail Making Test Part B minus Part A) in 894 recipients (2009–2021) at KT, 1/3/6-months, 1-year, and annually post-KT. Dementia was ascertained using linked Medicare claims. We described repeated measures of cognitive performance (mixed effects model) and quantified dementia risk (Fine & Gray competing risk) by post-KT delirium. Of 894 recipients, 43(4.8%) had post-KT delirium. Delirium was not associated with global cognitive function at KT (difference = −3.2 points, 95%CI: −6.7, 0.4) or trajectories post-KT (0.03 points/month, 95%CI: −0.27, 0.33). Delirium was associated with worse executive function at KT (55.1 s, 95%CI: 25.6, 84.5), greater improvements in executive function <2 years post-KT (−2.73s/month, 95%CI: −4.46,−0.99), and greater decline in executive function >2 years post-KT (1.72s/month, 95%CI: 0.22, 3.21). Post-KT delirium was associated with over 7-fold greater risk of dementia post-KT (adjusted subdistribution hazard ratio= 7.84, 95%CI: 1.22, 50.40). Transplant centers should be aware of cognitive risks associated with post-KT delirium and implement available preventative interventions to reduce delirium risk.
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影响因子：
2.1
作者：
Chu NM;Chen X;Gross AL;Carlson MC;Garonzik-Wang JM;Norman SP;Mathur A;Abidi MZ;Brennan DC;Segev DL;McAdams-DeMarco MA
通讯作者：
McAdams-DeMarco MA
影响因子：
1.1
作者：
Birhanu, Teshome;Molenberghs, Geert;Kenward, Michael G.
通讯作者：
Kenward, Michael G.
影响因子：
3.7
作者：
del Mar Sanchez-Fernandez, Maria;Reyes del Paso, Gustavo A.;Jose Fernandez-Serrano, Maria
通讯作者：
Jose Fernandez-Serrano, Maria
影响因子：
2.1
作者：
Gabrio, Andrea;Plumpton, Catrin;Banerjee, Sube;Leurent, Baptiste
通讯作者：
Leurent, Baptiste
影响因子：
6.3
作者：
American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults
通讯作者：
American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults