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Neural predisposing factors of postoperative delirium in elderly patients with femoral neck fracture

 Sunghyon Kyeong  ;  Jung Eun Shin  ;  Kyu Hyun Yang  ;  Woo Suk Lee  ;  Tae-Sub Chung  ;  Jae-Jin Kim 
 Scientific Reports, Vol.8(1) : 7602, 2018 
Journal Title
 Scientific Reports 
Issue Date
Elderly adults are more likely to develop delirium after major surgery, but there is limited knowledge of the vulnerability for postoperative delirium. In this study, we aimed to identify neural predisposing factors for postoperative delirium and develop a prediction model for estimating an individual's probability of postoperative delirium. Among 57 elderly participants with femoral neck fracture, 25 patients developed postoperative delirium and 32 patients did not. We preoperatively obtained data for clinical assessments, anatomical MRI, and resting-state functional MRI. Then we evaluated gray matter (GM) density, fractional anisotropy, and the amplitude of low-frequency fluctuation (ALFF), and conducted a group-level inference. The prediction models were developed to estimate an individual's probability using logistic regression. The group-level analysis revealed that neuroticism score, ALFF in the dorsolateral prefrontal cortex, and GM density in the caudate/suprachiasmatic nucleus were predisposing factors. The prediction model with these factors showed a correct classification rate of 86% using a leave-one-out cross-validation. The predicted probability computed from the logistic model was significantly correlated with delirium severity. These results suggest that the three components are the most important predisposing factors for postoperative delirium, and our prediction model may reflect the core pathophysiology in estimating the probability of postoperative delirium.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김재진(Kim, Jae Jin) ORCID logo https://orcid.org/0000-0002-1395-4562
양규현(Yang, Kyu Hyun) ORCID logo https://orcid.org/0000-0001-7183-588X
이우석(Lee, Woo Suk) ORCID logo https://orcid.org/0000-0002-0798-1660
정태섭(Chung, Tae Sub)
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