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. (C) 2020 Elsevier Inc. All rights reserved.