3/24/2024 0 Comments Moca test version 7.3 pdfThe risk factors for DNR could vary for patients undergoing different types of major surgery. In the present study, we planned to follow up with participants at POD30. Besides, most previous studies evaluated the cognitive function within 1 week after surgery patients were only followed up until discharge, and there was a lack of long-term follow-up. Systemic inflammatory response and severe persistent pain after surgery causes cognitive negative events. Furthermore, postoperative pain resulting from thoracic surgery is usually more severe than the pain caused by other major surgery and is influenced by neuropathic pain caused by thoracotomy. Thoracic surgery often requires one-lung ventilation, which is accompanied with important physiological disturbances, and leads to a pulmonary arteriovenous shunt with the decrease of arterial oxygen content and an exaggerated activation of inflammatory processes. The clinical relevance of delayed neurocognitive recovery after thoracic surgery requires more attention.Īlthough several studies have reported various risk factors for DNR after non-cardiac major surgery, the risk factors for DNR in elderly patients undergoing thoracic surgery are still poorly understood. Identifying potential DNR risk factors is of utmost importance to facilitate risk stratification and preventive efforts. It also poses a great economic burden to society. As such, it constitutes a major public health concern considering that patients with DNR at discharge were found to have increased mortality at 3 months or 1 year after surgery. Thus far, DNR has been associated with several perioperative complications, resulting in a prolonged hospital stay. Previous studies have shown that, in elderly patients undergoing thoracic surgery, the occurrence of DNR within 1 week after surgery is 20–60% however, there are very few studies on the incidence of cognitive recovery delay in elderly patients who underwent thoracic surgery at 30 days after surgery. Delayed postoperative neurocognitive recovery (DNR) occurs in 15–50% of elderly surgical patients on the day of hospital discharge. It is a common postoperative complication in elderly patients characterized by impairments in memory and attention, usually detected by neuropsychological tests. The risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery include diabetes, perioperative inadvertent hypothermia (< 35℃), VICA (sevoflurane combined with propofol anesthesia), and history of cerebrovascular events.ĭelayed neurocognitive recovery (DNR) is defined as a cognitive decline that occurs within 30 days of surgery. Diabetes mellitus (OR = 6.508, P = 0.001), perioperative inadvertent hypothermia (< 35℃) (OR = 5.688, P = 0.005), history of cerebrovascular events (OR = 10.211, P < 0.001), and VICA (sevoflurane combined with propofol anesthesia) (OR = 5.306, P = 0.022) resulted as independent risk factors of delayed neurocognitive recovery. On the 30th day after surgery, 26 (16.88%) patients had delayed postoperative cognitive recovery, and 128 (83.12%) had postoperative cognitive function recovery. Patients had an average preoperative MoCA score of 24.68 ± 2.75. ResultsĪ total of 154 patients (55.8% men) with an average age of 67.99 ± 3.88 years were finally included. Univariate and multivariate logistic regression models were used to analyze the risk factors for DNR. Cognitive function was tested by MoCA tests that were performed by the same trained physician before surgery, on postoperative day 4 (POD4), and on postoperative day 30 (POD30). MethodsĪ total of 215 elderly patients who underwent thoracic surgery between May 2022 and October 2022 were recruited in this prospective observational study. To investigate the risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery.
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