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https://hdl.handle.net/2440/92739
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Type: | Journal article |
Title: | Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery |
Author: | Silbert, B. Evered, L. Scott, D. McMahon, S. Choong, P. Ames, D. Maruff, P. Jamrozik, K. |
Citation: | Anesthesiology, 2015; 122(6):1224-1234 |
Publisher: | Kluwer |
Issue Date: | 2015 |
ISSN: | 0003-3022 1528-1175 |
Statement of Responsibility: | Brendan Silbert, Lisbeth Evered, David A. Scott, Stephen McMahon, Peter Choong, David Ames, Paul Maruff, Konrad Jamrozik |
Abstract: | Background: This study investigated the prevalence of cognitive impairment in elderly noncardiac surgery patients and any association between preoperative cognitive impairment and postoperative cognitive dysfunction (POCD). Additionally, the incidence of cognitive decline at 12 months after surgery was identified. Methods: Three hundred patients for hip joint replacement and 51 nonsurgical controls aged 60 yr or older were studied in a prospective observational clinical trial. All study participants and controls completed a battery of eight neuropsychological tests before surgery and at 7 days, 3 months, and 12 months afterwards. Preoperative cognitive status was assessed using preexisting cognitive impairment (PreCI) defined as a decline of at least 2 SD on two or more of seven neuropsychological tests compared to population norms. POCD and cognitive decline were assessed using the reliable change index utilizing the results of the control group. Results: PreCI was classified in 96 of 300 (32%) patients (95% CI, 23 to 43%). After surgery, 49 of 286 (17%) patients (95% CI, 13 to 22%) and 27 of 284 (10%) patients (95% CI, 6 to 13%) demonstrated POCD at 7 days and 3 months, respectively, while 7 of 271 (3%) patients (95% CI, 1 to 4%) demonstrated cognitive decline at 12 months. Patients with PreCI had a significantly increased incidence of POCD at 7 days and 3 months and cognitive decline at 12 months. Conclusions: Patients with PreCI have an increased incidence of POCD and cognitive decline. PreCI is a good predictor of subsequent POCD and cognitive decline. The incidence of cognitive decline after 12 months in this group of patients is low. |
Keywords: | Humans Disease Progression Postoperative Complications Arthroplasty, Replacement, Hip Prospective Studies Cognition Disorders Neuropsychological Tests Aged Aged, 80 and over Middle Aged Female Male Consciousness Monitors Preexisting Condition Coverage |
Rights: | Copyright © 2015, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited |
DOI: | 10.1097/aln.0000000000000671 |
Published version: | http://dx.doi.org/10.1097/aln.0000000000000671 |
Appears in Collections: | Aurora harvest 7 Public Health publications |
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