Cognitive Function and Postoperative Outcomes in Patients with Head and Neck Cancer.

Area of Science:

• Neurosurgery
• Oncology
• Gerontology

Background:

• Cognitive impairment is common in patients undergoing major surgery.
• Assessing preoperative cognitive function is crucial for predicting postoperative outcomes.

Purpose of the Study:

• To determine the relationship between preoperative cognitive function and postoperative outcomes in patients undergoing major head and neck cancer surgery.
• To investigate the association between Montreal Cognitive Assessment (MoCA) scores and outcomes such as delirium, discharge disposition, and readmission.

Main Methods:

• Retrospective cohort study of 135 patients undergoing major surgery for aerodigestive or head and neck cancer.
• Preoperative Montreal Cognitive Assessment (MoCA) scores were analyzed.
• Outcomes included postoperative delirium, discharge disposition, and 30-day emergency department return or readmission.

Main Results:

• The average preoperative MoCA score was 23.4.
• 35% of patients had normal cognitive status (MoCA ≥26), while 65% had some degree of cognitive impairment.
• Lower MoCA scores were significantly associated with non-home discharge disposition and prolonged hospital stay.

Conclusions:

• Preoperative cognitive function, as measured by MoCA, is a significant predictor of discharge destination and length of hospital stay in head and neck cancer patients.
• These findings highlight the importance of cognitive assessment in surgical planning and patient management.