Dr. Brown’s Research

Prevention and Consequences of Postoperative Delirium

Among older adults, delirium and cognitive decline after surgery are common and have been associated with increased morbidity, mortality, and decline in functional status. Thus, preventing these potentially interrelated complications is critical. Dr. Brown’s specific research goals are (1) to conduct a novel pilot trial of anesthetic management to reduce postoperative delirium, and (2) to determine the independent association of postoperative delirium and subsequent cognitive decline. Dr. Brown’s career research goal is to conduct multi-center clinical trials to reduce delirium and cognitive decline in older adults after surgery.

Dr. Brown and his team will conduct a pilot randomized controlled trial. They will determine whether randomization to light sedation with spinal anesthesia reduces the incidence of postoperative delirium in patients undergoing spine surgery compared to general anesthesia. Dr. Brown and his team will determine the independent association of postoperative delirium and cognitive change from baseline to 1-month and 1-year after cardiac surgery. They will also examine specific characteristics that are associated with greater cognitive decline after delirium.

Dr. Brown’s focus will continue in both analysis of cognitive outcomes and conduct of a clinical trial. If reduced depth of anesthesia were shown to reduce delirium, and delirium were independently associated with cognitive decline, these results would fundamentally alter anesthetic management in older adults and would support a large multi-centered trial of reduction in depth of anesthesia to prevent both delirium and cognitive decline.

Related Publications

Association of hospitalization with long-term cognitive and brain MRI changes in the ARIC cohort.
Brown CH 4th, Sharrett AR, Coresh J, Schneider AL, Alonso A, Knopman DS, Mosley TH, Gottesman RF.

Objective: To determine whether hospitalization is associated with subsequent cognitive decline or changes on brain MRI in a community-based cohort. Baseline and follow-up cognitive testing (n = 2,386) and MRI scans with standardized assessments (n = 885) were available from a subset of white and black participants in the Atherosclerosis Risk in Communities study. Cognitive tests included the Delayed Word Recall Test …

Length of red cell unit storage and risk for delirium after cardiac surgery.
Brown CH 4th, Grega M, Selnes OA, McKhann GM, Shah AS, LaFlam A, Savage WJ, Frank SM, Hogue CW, Gottesman RF.

The time that red cell units are stored before transfusion may be associated with postoperative complications, although the evidence is conflicting. However, the association between the length of red cell unit storage and postoperative delirium has not been explored. We hypothesized that the length of storage of transfused red cell units would be associated with delirium after cardiac surgery…

Read Dr. Brown’s recent publications and articles.