Clinical Analysis of Risk Factors of Postoperative Cognitive Dysfunction in Elderly Patients after Abdominal Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Li , DING Siqin , WANG Zhenliang , ZHANG Huazhou.

Department of General Surgery, The Second Affiliated Hospital of Xi’an Medical University, Xi’an 710038, Shaanxi Province, China;

Corresponding author：

Keywords：

Abdominal surgery; Postoperative cognitive dysfunction; Risk factor

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ObjectiveTo analyze the risk factors of postoperative cognitive dysfunction (POCD) in elderly patients after abdominal surgery. MethodsThe clinical data of 2 286 patients over 60 years old after abdominal surgery were retrospectively analyzed, which were divided into non-POCD group with 2 248 patients and POCD group with 38 patients. The influencing factors of POCD in elderly patients after abdominal surgery, including the age, gender, anesthetic way, the premedication, cormobided with lung or heart disease, diabetes, jaundice, anemia or hypoproteinemia, the duration of surgery, and postoperative analgesia protocols, were analyzed between two groups. ResultsThe age, anesthetic way, cormobided with lung or heart disease, diabetes, jaundice, with or without continuous postoperative effective analgesia, and surgery duration over four hours were relevant with POCD (P lt;0.05), while gender, the premedication, and preexisted anemia or hypoproteinemia were not relevant with that (P gt;0.05). ConclusionAge over 70 years, general anaesthesia, cormobided with lung or heart disease, diabetes, jaundice, surgery duration over four hours, and incomplete postoperative analgesia are the risk factors of POCD after abdominal surgery.

Citation： LIU Li,DING Siqin,WANG Zhenliang,ZHANG Huazhou.. Clinical Analysis of Risk Factors of Postoperative Cognitive Dysfunction in Elderly Patients after Abdominal Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(9): 987-990. doi: Copy

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9.	D’Amato CP, Denney RL. The diagnostic utility of the rarely missed index of the Wechsler memory scalethird edition in detecting response bias in an adult male incarcerated setting [J]. Arch Clin Neuropsychol, 2008, 23(5): 553561.
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14.	Newman MF, Kirchner JL, PhillipsBute B, et al. Longitudinal assessment of neurocognitive function after coronaryartery bypass surgery [J]. N Engl J Med, 2001, 344(6): 395402.
15.	Reich DL. Central nervous system protection in cardiac surgery [J]. Semin Cardiothorac Vasc Anesth, 2010, 14(1): 3237.
16.	鲍杨, 史东平, 封卫征. 老年患者术后认知功能障碍的研究进展 [J]. 中国老年学杂志, 2009, 29(20): 26892692.
17.	Coburn M, Fahlenkamp A, Zoremba N, et al. Postoperative cognitive dysfunction: Incidence and prophylaxis [J]. Anaesthesist, 2010, 59(2): 177184.
18.	Bittner EA, Yue Y, Xie Z. Brief review: anesthetic neurotoxicity in the elderly, cognitive dysfunction and Alzheimer’s disease [J]. Can J Anaesth, 2011, 58(2): 216223.
19.	Bilotta F, Doronzio A, Stazi E, et al. Postoperative cognitive dysfunction: toward the Alzheimer’s disease pathomechanism hypothesis [J]. J Alzheimers Dis, 2010, 22(3): 8189.
20.	Whitmer RA. Type 2 diabetes and risk of cognitive impairment and dementia [J]. Curr Neurol Neurosci Rep, 2007, 7(5): 373380.
21.	孙增荣, 王建华. 2型糖尿病认知功能损害研究进展 [J]. 国际内分泌代谢杂志, 2006, 26(1): 5759.
22.	Delrieu J, Piau A, Caillaud C, et al. Managing cognitive dysfunction through the continuum of Alzheimer’s disease: role of pharmacotherapy [J]. CNS Drugs, 2011, 25(3): 213226.
23.	姜建利, 席琳, 李宝安, 等. 四种措施防治老年患者术后认知功能障碍的比较 [J]. 中国实用医药, 2010, 5(28): 247248.
24.	赵华, 来怡农. 星状神经节阻滞防治老年术后认知功能障碍50例临床分析 [J]. 中国老年学杂志, 2010, 30(1): 113114.

1. Fodale V, Santamaria LB, Schifilliti D, et al. Anaesthetics and postoperative cognitive dysfunction: a pathological mechanism mimicking Alzheimer’s disease [J]. Anaesthesia, 2010, 65(4): 388395.
2. Hanning CD. Postoperative cognitive dysfunction [J]. Br J Anaesth, 2005, 95(1): 8287.
3. Krenk L, Rasmussen LS, Kehlet H. New insights into the pathophysiology of postoperative cognitive dysfunction [J]. Acta Anaesthesiol Scand, 2010, 54(8): 951956.
4. 黄海兵, 余崇林. 术后认知功能障碍研究新进展 [J]. 中国老年保健医学, 2011, 9(1): 5355.
5. Newman S, Stygall J, Hirani S, et al. Postoperative cognitive dysfunction after noncardiac surgery: a systematic review [J]. Anesthesiology, 2007, 106(3): 572590.
6. Diagnostic and Statistical Manual of Mental Disorders [M]. Fourth Edition. American Psychiatry Association, Washington DC, 1994: 273292.
7. Funder KS, Steinmetz J, Rasmussen LS. Methodological issues of postoperative cognitive dysfunction research [J]. Semin Cardiothorac Vasc Anesth, 2010, 14(2): 119122.
8. Fong TG, Fearing MA, Jones RN, et al. Telephone interview for cognitive status: creating a cross walk with the minimental state examination [J]. Alzheimers Dement, 2009, 5(6): 492497.
9. D’Amato CP, Denney RL. The diagnostic utility of the rarely missed index of the Wechsler memory scalethird edition in detecting response bias in an adult male incarcerated setting [J]. Arch Clin Neuropsychol, 2008, 23(5): 553561.
10. 杨纯勇, 易斌, 郭巧, 等. 术后认知功能障碍的临床评估工具进展 [J]. 重庆医学, 2010, 39(17): 23192320.
11. Ramaiah R, Lam AM. Postoperative cognitive dysfunction in the elderly [J]. Anesthesiol Clin, 2009, 27(3): 485496.
12. Kalkman C. Can we influence postoperative cognitive dysfunction? [J]. Acta Anaesth Belg, 2007, 58(4): 227229.
13. Mandal PK, Schifilliti D, Mafrica F, et al. Inhaled anesthesia and cognitive performance [J]. Drugs Today (Barc), 2009, 45(1): 4754.
14. Newman MF, Kirchner JL, PhillipsBute B, et al. Longitudinal assessment of neurocognitive function after coronaryartery bypass surgery [J]. N Engl J Med, 2001, 344(6): 395402.
15. Reich DL. Central nervous system protection in cardiac surgery [J]. Semin Cardiothorac Vasc Anesth, 2010, 14(1): 3237.
16. 鲍杨, 史东平, 封卫征. 老年患者术后认知功能障碍的研究进展 [J]. 中国老年学杂志, 2009, 29(20): 26892692.
17. Coburn M, Fahlenkamp A, Zoremba N, et al. Postoperative cognitive dysfunction: Incidence and prophylaxis [J]. Anaesthesist, 2010, 59(2): 177184.
18. Bittner EA, Yue Y, Xie Z. Brief review: anesthetic neurotoxicity in the elderly, cognitive dysfunction and Alzheimer’s disease [J]. Can J Anaesth, 2011, 58(2): 216223.
19. Bilotta F, Doronzio A, Stazi E, et al. Postoperative cognitive dysfunction: toward the Alzheimer’s disease pathomechanism hypothesis [J]. J Alzheimers Dis, 2010, 22(3): 8189.
20. Whitmer RA. Type 2 diabetes and risk of cognitive impairment and dementia [J]. Curr Neurol Neurosci Rep, 2007, 7(5): 373380.
21. 孙增荣, 王建华. 2型糖尿病认知功能损害研究进展 [J]. 国际内分泌代谢杂志, 2006, 26(1): 5759.
22. Delrieu J, Piau A, Caillaud C, et al. Managing cognitive dysfunction through the continuum of Alzheimer’s disease: role of pharmacotherapy [J]. CNS Drugs, 2011, 25(3): 213226.
23. 姜建利, 席琳, 李宝安, 等. 四种措施防治老年患者术后认知功能障碍的比较 [J]. 中国实用医药, 2010, 5(28): 247248.
24. 赵华, 来怡农. 星状神经节阻滞防治老年术后认知功能障碍50例临床分析 [J]. 中国老年学杂志, 2010, 30(1): 113114.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of Risk Factors of Postoperative Cognitive Dysfunction in Elderly Patients after Abdominal Surgery

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