Abstract
Introduction
The risk factors for postoperative cognitive dysfunction (POCD) after non-cardiac
surgery include advanced age and preexisting cognitive impairment.
Material and methods
Data was collected in a prospective manner on 220 patients of both genders. Patients
were triaged into three groups, with American Society of Anesthesiologists—ASA Physical
Classification System levels I–IV. Patients were 55 years of age and older, with self-reported alcohol abuse and were matched to age-,
sex-, and education-matched nonalcoholic controls. They were tested using a neurocognitive
battery before and two weeks after elective surgery or after a corresponding time
interval without surgery. Verbal memory, visuospatial memory, and executive functions
were assessed. Neurologic examination was performed in order to exclude subjects with
potential cerebrovascular damage. Standard laboratory analyses were done and findings
recorded. Significant predisposing factors for developing POCD were noted.
Results
From the total number of participants involved in the study, 135 (67.5%) patients
belonged to ASA class III. Among all patients, 168 (84%) patients were chronic alcohol
users. Pearson's χ2 test shows a statistically significant difference regarding the use of alcohol (χ2 = 19.220, df = 1, p = 0.000, p < 0.05). Significant three-way interactions (analysis of variance) for Visual Immediate
Recall, Visual Delayed Recall, Semantic Fluency, Phonemic Fluency, and the Color-Word
Stroop Test implied that cognitive performance in the alcoholic group decreased after
surgery.
Discussion
In the study by Mason which involved 255 elderly patients that were postoperatively
admitted to the intensive care unit following a major abdominal surgery, development
of POCD was two times greater in urgent cases (~40% of cases), when compared to elective interventions.
Conclusion
Our results complement the data given by the World Health Organization and results
of similar studies.
Keywords
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References
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Article info
Publication history
Published online: July 18, 2015
Accepted:
July 1,
2015
Received in revised form:
June 30,
2015
Received:
June 19,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
