Key result
The incidence of post-operative cognitive dysfunction in elderly patients undergoing non-cardiac surgery was not significantly different between those receiving general versus regional anesthesia (15.1% vs 25.9%, p=0.2).
Observational (n=200)
No
Absolute Event Rate: 15.1% vs 25.9%
p-value: p=0.2
Post-operative cognitive dysfunction is a notable complication in elderly patients undergoing non-cardiac surgery, with incidence declining over 30 days and higher risk observed in females.
No POCD difference by anesthesia type in this cohort; hypothesis-generating and should not yet change practice.
BACKGROUND AND AIMS: Aging population is a major demographic trend worldwide. Globally, 50% of all the elderly individuals are estimated to undergo atleast one surgical procedure and post-operative cognitive dysfunction (POCD) is one of the most common and often poorly understood post-operative complications in this section of the population. This randomised prospective study was conducted to assess the post-operative cognitive status in the elderly undergoing non-cardiac surgery, evaluate the cognitive parameters affected, evaluate the potential risk factors and thereby analyse the potential for implementation of preventive strategies. METHODS: This study was conducted on 200 patients aged 60 years or older scheduled for elective non-cardiac surgeries. The baseline cognitive status of the patients was assessed 2 days prior to the date of the surgery. The post-operative cognitive status was assessed on the 3(rd) day, 7(th) day and after 1 month. Statistical analysis was performed using SAS and SPSS. RESULTS: The incidence of POCD showed a gradual decline from postoperative day 3 to 30. Females were found to be at significant risk in developing POCD. Advancing age and level of education emerged as dominant factors, while type of anaesthesia, duration of surgery, and presence of coexisting comorbidities had no influence on the incidence of cognitive dysfunction. CONCLUSION: POCD is a definite complication after surgery and anaesthesia in the elderly population. Gender emerged as a significant risk factor with increasing age as a dominating factor contributing to POCD.
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Kotekar et al. (2014) conducted an observational in Post-operative cognitive dysfunction (n=200). General anesthesia vs. Regional anesthesia was evaluated on Incidence of post-operative cognitive dysfunction (POCD) (p=0.2). The incidence of post-operative cognitive dysfunction in elderly patients undergoing non-cardiac surgery was not significantly different between those receiving general versus regional anesthesia (15.1% vs 25.9%, p=0.2).