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Postoperative cognitive dysfunction 8 X more likely if low vitamin D – March 2018

Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub-analysis.

Acta Anaesthesiol Scand. 2018 Mar 26. doi: 10.1111/aas.13116
Zhang Y1, Shan GJ1, Zhang YX1, Cao SJ1, Zhu SN2, Li HJ3, Ma D4, Wang DX1.

  • 1 Department of Anaesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
  • 2 Department of Biostatics, Peking University First Hospital, Beijing, China.
  • 3 Peking University Clinical Research Institute, Beijing, China.
  • 4 Section of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Chelsea and Westminster Hospital, Imperial College London, London, UK.


Items in both categories Cognitive and Trauma-Surgery are listed here:

Trauma and surgery category starts with the following

  • You can easily improve outcomes of many planned surgeries by increasing vitamin D ahead of time
    • Cancer surgery is the only known exception - extra Vitamin D is OK only if doctor reduces the chemo doses
  • A loading dose of Vitamin D also improves unplanned hospital admissions
  • Improvements include
    • Shorter recovery time
    • Shorter ICU time
    • Reduced deaths – in hospital, next month, next year
    • Reduced Sepsis = blood poisoning = infection


  • "Postoperative cognitive dysfunction (POCD) is a decline in cognitive function (especially in memory and executive functions) that may last from a few days to a few weeks after surgery. In rare cases, this disorder may persist for several months after major surgery"
  • "POCD is common after cardiac surgery, and recent studies have now verified that POCD also exists after major non-cardiac surgery, although at a lower incidence. The risk of POCD increases with age, and the type of surgery is also important because there is a very low incidence associated with minor surgery.[3] POCD is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 years or older) are at significant risk for long-term cognitive problems."


Vitamin D is important for maintaining physiological functions including cognition and its deficiency is associated with the occurrence of cognitive impairment. This study was to explore the association between preoperative vitamin D status and the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing major surgery.

This was a predefined exploratory sub-analysis of one-centre data from a randomized controlled trial. In all, 123 elderly (≥ 65 years) patients who were scheduled to undergo major cancer surgery were recruited. Serum 25-hydroxyvitamin D concentration was measured before surgery. In total, 59 nonsurgical control subjects with comparable age and education level were also enrolled. A battery of neuropsychological tests was administered the day before and the 7th day after surgery in patients or at the same time interval in control subjects. POCD was diagnosed according to the ISPOCD1 definition.

71.5% (88/123) of elderly patients had vitamin D deficiency (serum 25-hydroxyvitamin D concentration < 12 ng/ml) before surgery; 24.4% (30/123) of them developed cognitive dysfunction at 1 week after surgery. After adjusting for confounding factors, high preoperative serum 25-hydroxyvitamine D concentration was related to a decreased risk of POCD (odds ratio [OR]: 0.829, 95% confidence interval [CI]: 0.708-0.971; P = 0.020), whereas preoperative vitamin D deficiency was associated with an increased risk of POCD (OR: 8.427, 95% CI: 1.595-44.511; P = 0.012).

Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.

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Created by admin. Last Modification: Sunday February 10, 2019 19:33:35 GMT-0000 by admin. (Version 11)

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