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Nomogram to predict postoperative cognitive dysfunction in elderly patients undergoing gastrointestinal tumor
Huifan Huang1, Jing Chou2, Yongzhong Tang1
1Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China.
Frontiers in Aging Neuroscience
|November 17, 2022
Summary
A new nomogram predicts postoperative cognitive dysfunction (POCD) in elderly patients after gastrointestinal surgery. This tool aids in preventing and managing POCD by identifying high-risk individuals.
Area of Science:
- Geriatric Medicine
- Surgical Oncology
- Neuroscience
Background:
- Postoperative cognitive dysfunction (POCD) is a significant concern in elderly patients undergoing major surgery.
- Gastrointestinal tumor resection is associated with a notable incidence of POCD, impacting patient recovery and outcomes.
- Accurate prediction of POCD risk is crucial for timely intervention and management strategies.
Purpose of the Study:
- To develop and validate a nomogram model for predicting the risk of postoperative cognitive dysfunction (POCD).
- To identify key clinical and laboratory factors associated with POCD in elderly patients undergoing gastrointestinal tumor resection.
- To provide a practical tool for clinicians to assess individual POCD risk.
Main Methods:
- A cohort of 369 elderly patients undergoing elective gastrointestinal tumor resection was studied.
- Cognitive function was assessed using the Mini-Mental State Examination (MMSE) preoperatively and postoperatively.
- Logistic regression analysis identified risk factors, and a nomogram was constructed and validated using AUROC and calibration plots.
Main Results:
- The incidence of POCD was 21.4% (79 out of 369 patients).
- The predictive nomogram incorporated age, BMI, cerebrovascular disease history, preoperative WBC and Hb levels, intra-operative blood loss, and operation time.
- The nomogram demonstrated good predictive performance (AUC = 0.710) and calibration, with clinical utility shown by decision curve analysis.
Conclusions:
- This study presents the first nomogram specifically designed for predicting POCD in elderly patients undergoing gastrointestinal tumor resection.
- The developed nomogram is an effective tool for assessing POCD risk, offering valuable insights for clinical decision-making.
- This scoring system can guide preventive measures and treatment strategies for POCD in this vulnerable patient population.
Keywords:
gastrointestinal tumorsnomogrampostoperative cognitive dysfunctionprediction modelrisk factorsMore Related Videos
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