Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study...

Area of Science:

• Gerontology
• Anesthesiology
• Neuroscience

Background:

• Postoperative cognitive dysfunction (POCD) is a concern in elderly patients undergoing surgery.
• Age is a suspected risk factor, with hypoxemia and hypotension being investigated as potential causes.

Purpose of the Study:

• To investigate the role of age, hypoxemia, and arterial hypotension as risk factors for POCD in elderly patients.
• To assess the incidence and risk factors for early and late POCD.

Main Methods:

• A multicenter study involving 1218 patients aged 60 years or older undergoing major non-cardiac surgery.
• Neuropsychological tests were administered preoperatively and at 1 week and 3 months postoperatively.
• Continuous monitoring of oxygen saturation and frequent blood pressure recordings were performed.

Main Results:

• POCD was observed in 25.8% of patients at 1 week and 9.9% at 3 months, significantly higher than control groups.
• Risk factors for early POCD included increasing age, longer anesthesia duration, less education, a second operation, infections, and respiratory complications.
• Only increasing age was identified as a significant risk factor for late POCD. Hypoxemia and hypotension were not significant risk factors.

Conclusions:

• Age is a confirmed risk factor for both early and late POCD.
• Hypoxemia and hypotension are not significant causative factors for POCD.
• Findings are crucial for patient counseling and future research on cognitive decline after surgery.