Vitamin D and Postoperative Delirium After Coronary Artery Bypass Grafting: A Prospective Cohort Study
Objective
Postoperative delirium is the most common neuropsychiatric complication after cardiac surgery. Vitamin D contributes to numerous brain processes, regulation of neurotrophic factors, neuroprotection, neuroplasticity, and brain development, which could play a role in delirium pathophysiology. The authors evaluated the association of admission serum levels of 25-hydroxyvitamin D [25(OH)D] with the occurrence of delirium after coronary artery bypass surgery.
Design
A prospective cohort study.
Setting
University hospital.
Participants
Coronary artery bypass surgery patients.
Measurements and Main Results
Serum levels of 25(OH)D were measured for 398 patients upon admission. Delirium was measured using the confusion assessment method for the intensive care unit.
Results
Postoperative delirium was detected in 17% (n = 68) of the patients. 25(OH)D deficiency (less than 20 ng/dL) was found in 41.2% (n = 164) of the patients. The median serum level of 25(OH)D was 21 ng/dL (12.8-32.85) in delirium and 24.2 ng/dL (14.4-42.5) in nondelirium patients (p = 0.04). Multivariate regression analysis adjusted by other risk factors indicated that admission severe hypovitaminosis D was associated with the occurrence of delirium (odds ratio = 3.18; 95% confidence interval: 1.29-7.78; p = 0.01).
Conclusions
Preoperative severe vitamin D deficiency was associated with the occurrence of delirium after coronary artery bypass grafting surgery.
