Li Fangfang, Miao Mengrong, Li Ningning, Zhou Jun, Sun Mingyang, Zhang Jiaqiang
Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Front Hum Neurosci. 2023 Jul 20;17:1234018. doi: 10.3389/fnhum.2023.1234018. eCollection 2023.
Preoperative cognitive impairment (PCI) may increase the incidence of postoperative delirium (POD), yet screening for cognitive impairment is rarely performed. This study hypothesized that Mini-Cog for preoperative cognitive impairment screening predicts postoperative delirium.
The prospective observational study recruited 153 elderly patients presenting for elective thoracic surgery. Cognitive function of these patients was screened using Mini-Cog preoperatively. We considered that patients with Mini-Cog scores ≤ 3 had cognitive impairment. Delirium was assessed using the Short CAM scale on postoperative days 1-5.
Of the 153 participants, 54 (35.3%) were assigned to the PCI group, and 99 (64.7%) were assigned to the Normal group. Place of residence, education level, and history of hypertension were significantly different between the two groups ( < 0.05). 51 (33.3%) patients developed POD. Multifactorial analysis revealed that PCI (OR = 2.37, = 0.028), older age (OR = 1.13, = 0.009), ASA grade III (OR = 2.75, = 0.012), and longer duration of anesthesia (OR = 1.01, = 0.007) were associated with POD.
Preoperative cognitive impairment is strongly associated with POD. Mini-Cog could be recommended for screening PCI.
ClinicalTrials.gov, identifier NCT05798767.
术前认知功能障碍（PCI）可能会增加术后谵妄（POD）的发生率，但很少进行认知功能障碍筛查。本研究假设，用于术前认知功能障碍筛查的简易认知评估量表（Mini-Cog）可预测术后谵妄。
这项前瞻性观察性研究招募了153例拟行择期胸外科手术的老年患者。术前使用简易认知评估量表对这些患者的认知功能进行筛查。我们认为简易认知评估量表得分≤3分的患者存在认知功能障碍。在术后1至5天使用简短意识错乱评估法（Short CAM）评估谵妄情况。
153名参与者中，54名（35.3%）被分配到PCI组，99名（64.7%）被分配到正常组。两组之间的居住地点、教育程度和高血压病史存在显著差异（P < 0.05）。51名（33.3%）患者发生了POD。多因素分析显示，PCI（比值比[OR]=2.37，P = 0.028）、年龄较大（OR = 1.13，P = 0.009）、美国麻醉医师协会（ASA）分级为III级（OR = 2.75，P = 0.012）和麻醉持续时间较长（OR = 1.01，P = 0.007）与POD相关。
术前认知功能障碍与POD密切相关。可推荐使用简易认知评估量表筛查PCI。
ClinicalTrials.gov，标识符NCT05798767。
