Key result
Early postoperative cognitive dysfunction occurred in 15.6% of children after noncardiac surgery, with surgical history, anesthesia duration, and early fever identified as independent risk factors.
Why the study?
While cognitive and behavioral alterations are common in children after cardiac surgery, whether postoperative cognitive dysfunction occurs in children undergoing noncardiac surgery was not known.
What is the incidence and what are the risk factors for early postoperative cognitive dysfunction in children undergoing noncardiac surgery?
Cohort (n=300)
What is the incidence and what are the risk factors for early postoperative cognitive dysfunction in children undergoing noncardiac surgery?
Early postoperative cognitive dysfunction occurs in approximately 15.6% of children undergoing noncardiac surgery, with risk increased by prior surgery, longer anesthesia duration, and early postoperative fever.
Identifies risk factors for early POCD in pediatric noncardiac surgery; may inform monitoring but leaves open prospective validation.
In children after cardiac surgery, alterations in cognitive ability and behavior are increasingly common, but whether postoperative cognitive dysfunction (POCD) occurs in children undergoing noncardiac surgery is not known. The present study was performed to investigate the incidence rate and potential risk factors of early neurocognitive dysfunction in children after noncardiac surgery. Two hundred patients aged between 4 and 14 years old underwent elective noncardiac surgery and 100 healthy age‐matched controls were enrolled in this prospective observational study. Wechsler Preschool and Primary Scale of Intelligence or Wechsler Intelligence Scale for Children‐Revised were conducted 1 day before and 3 days after surgery. POCD was calculated and diagnosed as a combined Z score. Any factors that differed between POCD and non‐POCD group (p < 0.10) were tested together by multivariate logistic regression analysis against the cognitive outcome of patients, to find out the independent risk factors of POCD. The general incidence of POCD was 15.6%. The univariate analysis revealed that POCD was associated with general anesthesia, surgical and anesthesia duration, early postoperative fever (EPF), and surgical history. However, only the history of surgery (p = 0.029), anesthesia duration (p = 0.010), and EPF (p < 0.001) were demonstrated to be independent risk factors for POCD. The occurrence rate of early POCD after noncardiac surgery in children is 15.6%. Children who had surgical history, longer anesthesia duration, or EPF are more prone to develop POCD.
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Han et al. (2022) conducted a cohort in Children undergoing noncardiac surgery (n=300). Noncardiac surgery vs. Healthy age-matched controls was evaluated on Early postoperative cognitive dysfunction (POCD). Early postoperative cognitive dysfunction occurred in 15.6% of children after noncardiac surgery, with surgical history, anesthesia duration, and early fever identified as independent risk factors.
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