Key result
Although the risk of developing postoperative neurocognitive disorders is considered lower in ambulatory surgery, older and frail patients remain vulnerable, necessitating preoperative cognitive screening and preventive strategies.
Why the study?
Increasing numbers of older and sicker patients are undergoing complex ambulatory surgeries without close post-discharge monitoring, despite being at risk for postoperative neurocognitive disorders.
Preoperative frailty and cognitive impairment are key risk factors for postoperative neurocognitive disorders, emphasizing the need for routine cognitive screening and tailored preventive strategies even in ambulatory surgery settings.
Alerts clinicians to screen frail elderly before ambulatory procedures; leaves open optimal protocols pending prospective trials.
Postoperative neurocognitive disorders (PoNCDs), such as postoperative delirium and cognitive dysfunction or decline can occur after surgery, especially in older patients. This significantly affects patient morbidity and surgical outcomes. Among various risk factors, recent studies have shown that preoperative frailty is associated with developing these conditions. Although the mechanisms underlying PoNCDs remain unclear, neuroinflammation appears to play an important role in their development. For the prevention and treatment of PoNCDs, medication modification, a balanced diet, and prehabilitation and rehabilitation programs have been suggested. The risk of developing PoNCDs is thought to be lower in ambulatory patients. However, owing to technological advancements, an increasing number of older and sicker patients are undergoing more complex surgeries and are often not closely monitored after discharge. Therefore, equal attention should be paid to all patient populations. This article presents an overview of PoNCDs and highlights issues of particular interest for ambulatory surgery.
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In et al. (2024) conducted a review in Postoperative neurocognitive disorders (POD and POCD). Ambulatory surgery was evaluated. Although the risk of developing postoperative neurocognitive disorders is considered lower in ambulatory surgery, older and frail patients remain vulnerable, necessitating preoperative cognitive screening and preventive strategies.
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