Risk factors for postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing noncardiac surgery

doi:10.3969/j.issn.1006-7795.2018.03.011

Abstract

Abstract: Objective To investigate the risk factors of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) in elderly patients, and explore the relationship between POD and POCD.Methods Two hundreds and twenty ASAI-Ⅲ patients aged over or equal to 60 years old undergoing elective non-cardiac surgery were enrolled. Evaluate patients with the confusion assessment method(CAM) for diagnosis of POD on the day before and the 1st, 2nd, 3rd, 7th day after surgery. Also the neuropsychological test for diagnosis of POCD was evaluated on the day before and one week after surgery. According to whether with POD or POCD, the patients were divided respectively into two groups:POD group and non-POD group or POCD group and non-POCD group. Compare the perioperative clinical data between the two groups and binary Logistic regression analysis was used for definition the risk factors of POD and POCD. In addition, the patients were divided into two groups according to whether with POD to compare the rate of the incidence of POCD.Results The incidence of POD and POCD is respectively 12.8% and 44.1%. High ASA classification (OR=2.605,95% CI:1.160-3.067) and high visual analogue scale(VAS) score of the first day after surgery (OR=2.061,95% CI:1.024-2.549) are the risk factors of POCD in elderly patients. Gender (male) (OR=6.087,95% CI:1.685-14.893), high ASA classification (OR=4.548,95% CI:2.487-10.384),low body mass index(BMI) (OR=0.75,95% CI:0.601-0.939) and diabetes(OR=4.673,95% CI:1.209-8.674) are the risk factors of POD in elderly patients. The incidence of POCD in the POD group is 80%, which is much higher than the non-POD group (38.8%) (P<0.05).Conclusion High ASA classification and high VAS score of the first day are the risk factors of POCD in elderly patients. Male, high ASA classification,low BMI and diabetes are the risk factors of POD in elderly patients. The patients who have developed POD are easier to surfer from POCD.

Key words: postoperative delirium, postoperative cognitive dysfunction, risk factor, elderly patients

CLC Number:

R743.3

Mu Shanshan, Wu Yan, Wu Anshi, Liu Yang. Risk factors for postoperative delirium and postoperative cognitive dysfunction in elderly patients undergoing noncardiac surgery[J]. Journal of Capital Medical University, 2018, 39(3): 366-372.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.03.011

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I3/366

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