Almuzayyen Hisham A, Chowdhury Tumul, Alghamdi Abdulkareem S
Department of Anesthesiology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
Saudi J Anaesth. 2023 Oct-Dec;17(4):550-556. doi: 10.4103/sja.sja_529_23. Epub 2023 Aug 18.
Elderly patients undergoing surgery are at higher risk of life-altering and costly complications. This challenge is increasingly recognized with the growing geriatric surgical population. Advanced age and comorbid conditions, such as disability and frailty that often develop with age, are all independent risk factors of postoperative morbidity and mortality. A common factor in this age group is cognitive impairment, which poses a challenge for the patient and clinician in the perioperative setting. It affects the capacity for informed consent and limits optimization before surgery; furthermore, an existing impairment may progress in severity during the perioperative period, and new onset of signs of delirium or postoperative cognitive dysfunction may arise during postoperative recovery. In this article, we aim to review the current literature examining the latest definitions, diagnostic criteria, and preventive strategies that may ameliorate postoperative cognitive complications.
接受手术的老年患者面临改变生活且代价高昂的并发症的风险更高。随着老年外科手术人群的不断增加，这一挑战日益受到关注。高龄以及残疾和虚弱等常随年龄增长而出现的合并症，都是术后发病和死亡的独立危险因素。该年龄组的一个常见因素是认知障碍，这在围手术期给患者和临床医生都带来了挑战。它影响知情同意的能力，并限制手术前的优化；此外，现有的损伤可能在围手术期加重，并且在术后恢复期间可能出现谵妄或术后认知功能障碍的新症状。在本文中，我们旨在回顾当前研究最新定义、诊断标准以及可能改善术后认知并发症的预防策略的文献。
