Faculty of Nursing, Mahidol University, Bangkok, Thailand.
The Vice-Chancellor's Unit, University of Wollongong, Wollongong, New South Wales, Australia.
Nurs Open. 2024 Aug;11(8):e70023. doi: 10.1002/nop2.70023.
To explore the risk factors associated with postoperative cognitive dysfunction in older patients within the first 7 days after non-neurosurgical surgery and anaesthesia.
A systematic review.
Following, PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Checklist, a systematic review of studies published from January 2018 to January 2024. The literature search was conducted across six electronic online databases, including PubMed, EMBASE, Scopus, Ovid, MEDLINE and Science Direct, and the Johns Hopkins Nursing Evidence-Based Practice Evidence Rating Scale was used for study appraisal.
The initial search yielded 1750 studies. The review included 19 studies which comprised prospective observational, case-control and retrospective studies. The prevalence of postoperative cognitive dysfunction ranged from 19% to 64% among older adults undergoing non-neurosurgery. The identified risk factors were classified into three phases including preoperative, intraoperative and postoperative. Preoperative risk factors were found in age, educational attainment, malnutrition, preoperative biomarkers and co-morbidities. Intraoperative risk factors were the duration of the operation, blood loss during the operation and anaesthesia used. Postoperative risk factors consisted of postoperative biomarkers and postoperative pain.
The result from this review may assist researchers and healthcare providers in assessing the underlying causes and risk factors of postoperative cognitive dysfunction, and in formulating suitable preventative and therapeutic strategies for older adults with non-neurosurgery during the short-term postoperative period.
探讨非神经外科手术和麻醉后 7 天内老年患者术后认知功能障碍的相关危险因素。
系统评价。
遵循 PRISMA 2020（系统评价和荟萃分析的首选报告项目）检查表，对 2018 年 1 月至 2024 年 1 月发表的研究进行系统评价。文献检索在六个电子在线数据库中进行，包括 PubMed、EMBASE、Scopus、Ovid、MEDLINE 和 Science Direct，并使用约翰霍普金斯护理循证实践证据评级量表对研究进行评估。
最初的搜索产生了 1750 项研究。本综述纳入了 19 项研究，包括前瞻性观察性研究、病例对照研究和回顾性研究。非神经外科手术的老年患者术后认知功能障碍的患病率在 19%至 64%之间。确定的危险因素分为术前、术中、术后三个阶段。术前危险因素包括年龄、教育程度、营养不良、术前生物标志物和合并症。术中危险因素包括手术持续时间、手术过程中的失血量和使用的麻醉。术后危险因素包括术后生物标志物和术后疼痛。
本综述的结果可能有助于研究人员和医疗保健提供者评估术后认知功能障碍的潜在原因和危险因素，并制定适合非神经外科手术后短期老年患者的预防和治疗策略。
