Preexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery

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dc.contributor.authorSilbert, B.
dc.contributor.authorEvered, L.
dc.contributor.authorScott, D.
dc.contributor.authorMcMahon, S.
dc.contributor.authorChoong, P.
dc.contributor.authorAmes, D.
dc.contributor.authorMaruff, P.
dc.contributor.authorJamrozik, K.
dc.date.issued2015
dc.description.abstractBackground: 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.
dc.description.statementofresponsibilityBrendan Silbert, Lisbeth Evered, David A. Scott, Stephen McMahon, Peter Choong, David Ames, Paul Maruff, Konrad Jamrozik
dc.identifier.citationAnesthesiology, 2015; 122(6):1224-1234
dc.identifier.doi10.1097/aln.0000000000000671
dc.identifier.issn0003-3022
dc.identifier.issn1528-1175
dc.identifier.urihttp://hdl.handle.net/2440/92739
dc.language.isoen
dc.publisherKluwer
dc.rightsCopyright © 2015, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited
dc.source.urihttps://doi.org/10.1097/aln.0000000000000671
dc.subjectHumans
dc.subjectDisease Progression
dc.subjectPostoperative Complications
dc.subjectArthroplasty, Replacement, Hip
dc.subjectProspective Studies
dc.subjectCognition Disorders
dc.subjectNeuropsychological Tests
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectConsciousness Monitors
dc.subjectPreexisting Condition Coverage
dc.titlePreexisting cognitive impairment is associated with postoperative cognitive dysfunction after hip joint replacement surgery
dc.typeJournal article
pubs.publication-statusPublished

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