Cognitive dysfunction after minor surgery in the elderly

Acta Anaesthesiologica Scandinavica - Tập 47 Số 10 - Trang 1204-1210 - 2003
Jaume Canet1, Johan Ræder2, Lars S. Rasmussen3, Mats Enlund4, H. M. Kuipers5, C.D. Hanning6, J. Jolles7, K. Korttila8, Volkert Siersma9, Catherine Dodds10, Hanne Abildstrøm3, J. Robert Sneyd11, P. Vila1, L. Muñoz Corsini12, J. H. Silverstein13, Nielsen Ik14, Jes Fabricius Møller3
1Department of Anesthesia, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain,
2Department of Anesthesia, Ullevaal University Hospital, Oslo, Norway,
3Department of Anesthesia, Center of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark,
4Department of Anesthesia & Intensive Care, Samariterhemmets Sjukhus, University Hospital, Uppsala, Sweden,
5Eindhoven University of Technology, Eindhoven, The Netherlands
6Department of Anesthesia, Leicester General Hospital, Leicester, UK,
7Rijks-universiteit Limburg, Maastricht, the Netherlands,
8University of Helsinki Department of Anesthesia and Intensive Care, Helsinki, Finland,
9Department of Biostatistics, University of Copenhagen, Denmark
10Department of Anesthesia, South Cleveland Hospital, Middlesbrough, UK,
11Department of Anesthesia, Peninsula Medical School, Plymouth, UK,
12Department of Anesthesia, Fundacion Hospital Alcorcon, Madrid, Spain,
13Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY
14Department of Anesthesia, Bispebjerg Hospital, Copenhagen, Denmark

Tóm tắt

Background:  Major surgery is frequently associated with postoperative cognitive dysfunction (POCD) in elderly patients. Type of surgery and hospitalization may be important prognostic factors. The aims of the study were to find the incidence and risk factors for POCD in elderly patients undergoing minor surgery.Methods:  We enrolled 372 patients aged greater than 60 years scheduled for minor surgery under general anesthesia. According to local practice, patients were allocated to either in‐ (199) or out‐patient (173) care. Cognitive function was assessed using neuropsychological testing preoperatively and 7 days and 3 months postoperatively. Postoperative cognitive dysfunction was defined using Z‐score analysis.Results:  At 7 days, the incidence (confidence interval) of POCD in patients undergoing minor surgery was 6.8% (4.3–10.1). At 3 months the incidence of POCD was 6.6% (4.1–10.0). Logistic regression analysis identified the following significant risk factors: age greater than 70 years (odds ratio [OR]: 3.8 [1.7–8.7], P = 0.01) and in‐ vs. out‐patient surgery (OR: 2.8 [1.2–6.3], P = 0.04).Conclusions:  Our finding of less cognitive dysfunction in the first postoperative week in elderly patients undergoing minor surgery on an out‐patient basis supports a strategy of avoiding hospitalization of older patients when possible.

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Acta Anaesthesiologica Scandinavica

Tập 47 Số 10

1204-1210

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