| Predictive value of preoperative mild cognitive impairment for early postoperative cognitive dysfunction |
| Received:May 18, 2021 Revised:August 02, 2021 Click here to download the full text |
| Citation of this paper:ZHANG Jing-ya,DU Xue,BASNET Diksa,LIU Su,LIU Jian-hui.Predictive value of preoperative mild cognitive impairment for early postoperative cognitive dysfunction[J].Chinese Journal of Clinical Medicine,2022,29(1):58-63 |
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| Author Name | Affiliation | E-mail | | ZHANG Jing-ya | Department of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200333, China | | | DU Xue | Department of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200333, China | | | BASNET Diksa | Department of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200333, China | | | LIU Su | Department of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200333, China | | | LIU Jian-hui | Department of Anesthesiology, Tongji Hospital, Tongji University, Shanghai 200333, China | jianhuiliu_1246@163.com |
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| Abstract:Objective To evaluate the incidence rate of postoperative cognitive dysfunction (POCD) in patients with mild cognitive impairment (MCI) before operation and to evaluate the predictive value of MCI for early POCD. Methods The clinical data of 106 patients (>65 years old) undergoing non-cardiac and non-neurological operations in Tongji Hospital, Tongji University from September 2018 to June 2021 were retrospectively analyzed. All the included patients underwent neuropsychological evaluation at least one day before the operation and the seventh day after the operation. Four patients with mini-mental state examination (MMSE) score<23 points were excluded. The other patients were randomly divided into the experimental group (n=87) and the verification group (n=15). The patients in the experimental group were divided into MCI group and non-MCI group according to the MCI diagnostic criteria, and the incidence rate of early POCD was compared betweent the two subgroups. The risk factors of early POCD were analyzed by the logistic regression analysis, and the prediction model of early POCD was constructed. The prediction model was externally corroborated in the verification group, and the diagnostic value of the model was evaluated. Results There were 28 patients with MCI (32.2%), among whom 6 patients with early POCD (21.4%); 59 patients with non-MCI (67.8%), and among whom16 patients with early POCD (27.1%). There was no statistical difference in the incidence of early POCD between the two subgroups. Logistic regression analysis showed that the score of the digital symbol substitution test (DSST) was an independent risk factor for the occurrence of early POCD (P=0.03). The AUC value of the prediction model in the experimental group was 0.883 (95% CI 0.807-0.959) and that in the control group was 0.840 (98% CI 0.583-1.000). The calibration curve results showed that the prediction model had good stability. Conclusion For patients undergoing non-neurological and non-cardiac operations, the MCI before operation does not affect the occurrence of POCD in the early stage after the operation. However, when the DSST score decreases, POCD should be alerted. |
| keywords:cognitive impairment preoperation postoperation neuropsychological test the elderly |
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