Incidence and Risk Factors for Cognitive Dysfunction in Patients with Severe Systemic Disease

Incidence and Risk Factors for Cognitive Dysfunction in Patients with Severe Systemic Disease

OBJECTIVE: To determine the relevance of surgery and other causative factors to the incidence of postoperative cognitive dysfunction (POCD) in patients with severe systemic disease. METHODS: This observational study included 107 noncardiac surgical patients and 26 nonsurgical control subjects, all o...

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Bibliographic Details
Published in:Journal of international medical research Vol. 40; no. 2; pp. 612 - 620
Main Authors: Radtke, FM, Franck, M, Herbig, TS, Papkalla, N, Kleinwaechter, R, Kork, F, Brockhaus, WR, Wernecke, K-D, Spies, CD
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-04-2012
Subjects:
Aged
Aged, 80 and over
Anesthesia - adverse effects
Cognition Disorders - etiology
Elective Surgical Procedures
Female
Humans
Male
Mental Status Schedule
Middle Aged
Neuropsychological Tests
Postoperative Complications
Postoperative
Cognitive Dysfunction
American Society of Anesthesiologists (ASA) Physical Status
Severe Systemic Disease
Risk Factors
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Summary:OBJECTIVE: To determine the relevance of surgery and other causative factors to the incidence of postoperative cognitive dysfunction (POCD) in patients with severe systemic disease. METHODS: This observational study included 107 noncardiac surgical patients and 26 nonsurgical control subjects, all of whom had an American Society of Anesthesiologists physical classification status of 3. Cognitive assessment was performed preoperatively and 7 days postoperatively, or with a 7-day interval for the control group. POCD was calculated as a combined Z-score. Mini Mental State Examination (MMSE) was used to exclude patients with pre-existing cognitive deficit (MMSE score ≥ 23). Surgical and other factors including duration of surgery/anaesthesia and length of stay in the intensive care unit (ICU) were recorded. RESULTS: After 7 days, POCD was found in 40/107 (37.4%) surgical patients compared with 4/26 (15.4%) nonsurgical controls. Preoperative MMSE score, duration of surgery/anaesthesia, and length of stay in the ICU and hospital were associated with POCD. Logistic regression analysis revealed that preoperative MMSE score was an independent predictor of POCD. CONCLUSION: Lower baseline MMSE score was the only independent predictor for POCD in patients with severe systemic disease.
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ISSN:0300-0605
1473-2300
DOI:10.1177/147323001204000223