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Summary
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Postoperative neurocognitive disorder (POCD) affects 23% of older adults after non-cardiac surgery by day 7, decreasing over time. Abdominal surgery poses a higher POCD risk than orthopedic surgery, necessitating improved perioperative care.

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Area of Science:

  • Geriatric Medicine
  • Neuroscience
  • Surgical Outcomes

Background:

  • Older surgical patients face increased neurocognitive disorder risk due to multimorbidity and aging.
  • Postoperative neurocognitive disorder (POCD) prevalence in this demographic requires further investigation.
  • This study focuses on older adults undergoing non-cardiac surgery.

Purpose of the Study:

  • To estimate the pooled prevalence of perioperative neurocognitive disorder (POCD) in older adults undergoing non-cardiac surgery.
  • To analyze the temporal trends of POCD after surgery.
  • To compare POCD prevalence across different surgical types.

Main Methods:

  • Systematic review and meta-analysis of studies published up to January 24, 2024.
  • Inclusion of non-cardiac surgical inpatients aged 60 years and older with perioperative cognitive assessments.
  • Random-effects model used for pooled prevalence calculation; Newcastle-Ottawa Scale and MOOSE guidelines for quality assessment.

Main Results:

  • Thirty-nine studies (12,921 patients) were analyzed; mean age 70.0 ± 8.9 years, 44.3% women.
  • Overall POCD prevalence: 23% (day 7), 16% (1 month), 10% (3 months), 3% (1 year).
  • Abdominal surgery showed higher POCD prevalence than orthopedic surgery at day 7 and 3 months.

Conclusions:

  • POCD is prevalent in older non-cardiac surgical patients, with significant rates at 7 days and 1 month post-surgery.
  • Abdominal surgery is associated with a higher risk of POCD compared to orthopedic surgery.
  • Cognitive screening, risk mitigation, and interventions are crucial for better perioperative care and outcomes.