Cognitive dysfunction in older patients undergoing non-neurosurgery in the immediate postoperative period: A systematic review.
Pinyapat Kitthanyateerakul, Thitipong Tankumpuan, Patricia M Davidson
PMID 39189543WHAT IT FOUND
Older patients after non-neurosurgery can show postoperative cognitive decline within the first week, with reported incidence 22% to 41%; age, education, nutrition, comorbidities, surgery time, blood loss, anaesthesia and pain were associated.
Key findings
01Postoperative cognitive decline was reported in 22% to 41% of older patients assessed during the first week after non-neurosurgery.
02Preoperative age, lower education, poor nutrition and frailty were linked to postoperative cognitive decline.
03After surgery, pain score 4 or more on day 1 and POD duration 2 days or more were linked to postoperative cognitive decline.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not combine the studies into a meta-analysis because the included studies were too different. Only English-language studies were searched, so relevant studies in other languages may have been missed. The included studies were observational, so they show factors linked to postoperative cognitive decline, not that changing those factors prevents it. The review focused on assessment soon after surgery, so it does not describe cognitive problems that begin or persist later. Different cognitive tests and definitions were used across studies, so the reported incidence range may not be directly comparable.
Declared interests
No specific funding was received, and the authors declared no conflicts of interest.
The easy way to misread this
Do not read these factors as causes or as reasons to change a treatment alone; the review combined observational studies and could not pool their effects.