Key result
Pre-operative frailty linked to ~88% higher risk of early cognitive dysfunction after non-cardiac surgery.
Why the study?
Does pre-operative frailty increase the risk of post-operative delirium and cognitive dysfunction in elderly patients undergoing non-cardiac surgery?
Cohort (n=109)
Does pre-operative frailty increase the risk of post-operative delirium and cognitive dysfunction in elderly patients undergoing non-cardiac surgery?
Pre-operative frailty is associated with significantly increased post-operative cognitive dysfunction up to 3 months after non-cardiac surgery in elderly patients.
Supports frailty screening to identify elderly non-cardiac surgery patients needing cognitive monitoring; leaves open whether interventions reduce dysfunction.
JOURNAL/ijana/04.03/01762628-202203001-00020/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff JOURNAL/ijana/04.03/01762628-202203001-00020/inline-graphic2/v/2022-09-30T091728Z/r/image-tiff Background & Aims: Frailty is defined as result of a progressive decline in homeostatic capacity and is a vicious cycle. Delirium is defined as acute in onset, inattention, with cognition dysfunction and behaviour abnormalities Methods: Consenting patients above 65 years of age, undergoing non cardiac surgery were enrolled. Frailty was assessed preoperatively with Modified Fried Criteria (MFC) and patients were divided into Frail (MFC<3/7) and Non frail category (MFC>3/7). Postoperatively patients were assessed for delirium by Confusion assessment method , Montreal Cognitive Assessment and 12 item Mini-Mental State Examination on Day 1, Day 3, and telephonically by T-MOCA at 1 and 3 months postoperative Results: 109 patients were enrolled. Post-operative delirium on Day 1 was seen in 9 (8.25%) patients and all patients belonged to frail category. Cognitive dysfunction assessed by MOCA and MMSE on Day1 was seen in 85.7%(81/98) and 63.3% (62/98) in frail elderly significantly higher than 45.5% (5/11), and 27.3% (3/11) in non-frail elderlies. significantly greater cognitive dysfunction was seen in frail patients at Day3, at one month and at three months (77.6% in frail versus 36.4% in non-frail) too. Conclusion: In our study we found that pre-operative Frail elderly patients had significantly increased post-operative cognitive dysfunction at day 1, 3 and 1st month and 3rd month after non-cardiac surgery. Incidence of postoperative delirium however was similar
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Shweta Rani (2022) conducted a cohort in Elderly patients undergoing non-cardiac surgery (n=109). Pre-operative frailty vs. Non-frail was evaluated on Cognitive dysfunction assessed by MOCA on Day 1. Pre-operative frailty in elderly patients undergoing non-cardiac surgery was associated with significantly higher cognitive dysfunction on Day 1 (85.7% vs 45.5%) and at 3 months (77.6% vs 36.4%).
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