Boos Gustavo Luchi, Soares Luiz Fernando, Oliveira Filho Getúlio Rodrigues de
Anestesiologia da SES/SC.
Rev Bras Anestesiol. 2005 Oct;55(5):517-24. doi: 10.1590/s0034-70942005000500006.
Postoperative cognitive dysfunction (POCD) is related to factors such as physical status, electrolytic, visual and immune disorders, alcoholism, drugs and advanced age. This study aimed at determining the prevalence of POCD and its associated factors.
Participated in this prospective study 55 patients aged 18 to 89 years, scheduled for elective orthopedic, urologic, general or vascular surgeries, under general or regional anesthesia. The Mini-Mental State Examination (MMSE) was applied the day before surgery (M0), at 24 postoperative hours (M1) and 3 to 7 days after surgery (M2). POCD was defined as MMSE score below 24/30 or as a difference equal to or above 4 as compared to M0. Univariate and multivariate analysis variables included age, gender, type of anesthesia and surgery, intraoperative hypotension, hypoxemia or hypocapnia, use of atropine and surgery length.
POCD was observed in eight patients (14.54%). All POCD patients were above 65 years of age. Among these patients, the prevalence of POCD was 28.57%. Only age and preanesthetic MMSE scores were different between patients with or without POCD. The logistic model included only preanesthetic MMSE scores.
Among the variables included in this study, only preanesthetic MMSE score is a significant independent predictor of POCD.
术后认知功能障碍(POCD)与身体状况、电解质、视觉及免疫紊乱、酗酒、药物及高龄等因素相关。本研究旨在确定POCD的患病率及其相关因素。
55例年龄在18至89岁之间、计划接受择期骨科、泌尿外科、普通外科或血管外科手术、采用全身或区域麻醉的患者参与了这项前瞻性研究。在手术前一天(M0)、术后24小时(M1)以及术后3至7天(M2)进行简易精神状态检查表(MMSE)评估。POCD定义为MMSE评分低于24/30,或与M0相比差值等于或大于4。单因素和多因素分析变量包括年龄、性别、麻醉和手术类型、术中低血压、低氧血症或低碳酸血症、阿托品的使用以及手术时长。
8例患者(14.54%)出现POCD。所有POCD患者年龄均在65岁以上。在这些患者中,POCD的患病率为28.57%。有或无POCD的患者之间,仅年龄和麻醉前MMSE评分存在差异。逻辑模型仅包括麻醉前MMSE评分。
在本研究纳入的变量中,仅麻醉前MMSE评分是POCD的显著独立预测因素。