Correlation between preoperative cognitive ability, regional cerebral oxygen saturation and postoperative delirium in elderly Portuguese patients

"Intensive Literature Reading" to master the latest academic trends and expand anesthesia expertise to write scientific articles Welcome to Luffy Anesthesia Channel Association Among Preoperative Cognitive Performance, Regional Cerebral Oxygen Saturation, and Postoperative Delirium in Older Portuguese Patients Correlation between oxygen saturation and postoperative delirium 01 Background BACKGROUND: Postoperative delirium is common among older patients and preoperative identification of high-risk patients is widely recommended.
The aim of this study was to assess whether preoperative cognitive performance using brief screening tools or regional cerebral oxygen saturation (Scto2) was associated with the development of postoperative delirium in older Portuguese patients undergoing elective surgery.
Background: Postoperative delirium is common in older patients, so it is strongly recommended to identify high-risk patients before surgery
.

The aim of this study was to assess whether preoperative cognitive performance (assessed using a simple screening tool) or regional cerebral oxygen saturation (Scto2) were associated with the development of postoperative delirium in elderly Portuguese patients undergoing elective surgery
.

02METHODS: Prospective observational cohort study where preoperative cognitive screening tools (Mini-Cog, Mini-Mental State Examination, verbal fluency) and Scto2 (INVOS 5100C; Medtronic, Ireland) were assessed in 238 patients ≥65 years old undergoing elective surgery between July 2017 and May 2019 at a tertiary academic center in Portugal.
The primary outcome was postoperative delirium detected by the 3D-Confusion Assessment Method.
Data were analyzed by univariate analysis and multivariable logistic regression.
Method: Preoperative using a prospective cohort study The Cognitive Screening Tool (Mini-Cog, Mini-Mental State Examination, Verbal Fluency) and the Monitoring Scto2 Tool (INVOS 5100C; Medtronic, Ireland) were tested at a higher academic centre in Portugal between July 2017 and May 2019 238 patients ≥65 years of age who were scheduled for elective surgery were evaluated
.

The primary outcome was postoperative delirium detected by the 3D-Confusion Assessment Method
.

Data were analyzed by univariate analysis and multivariate logistic regression analysis
.

Note: Prospective cohort study: is the basic form of cohort study
.

The grouping of the study subjects was determined according to the current exposure status of the study subjects.
At this time, the results of the study have not yet appeared, and a period of prospective observation is required to obtain Table & Figuretable1 Baseline characteristics and univariate analysis of postoperative delirium Continuous variables: This variable is consists of numbers
.

Categorical variables such as age, follow-up time, height, weight, tumor size, lymph node metastasis score, etc.
: There are several groups under this variable
.

Such as age (>35 or ≤35 two groups), gender (two groups of men and women), tumor T stage, etc.
table2 multivariate Logistic regression model to study the relationship between possible cognitive impairment and postoperative delirium measured by Mini-Cog test Variables entered in the model: age, gender, ASA classification, long-term use of benzodiazepines, depression, years of formal education, frailty, risk of surgery Relationships between post-delirium variables entered in the model: age, sex, ASA class, long-term use of benzodiazepines, depression, years of formal education, frailty, risk of surgery The relationship between cognitive impairment and postoperative delirium Input variables in the model: age, gender, ASA class, long-term use of benzodiazepines, depression, years of formal education, frailty, surgical risk table5 Multivariate Logistic Regression Model Variables entered into the model to study the relationship between preoperative regional cerebral oxygen saturation and postoperative delirium: age, sex, ASA class, long-term benzodiazepine use, depression, years of formal education, frailty, surgical risk table6 Complete Spearman's Correlation Coefficient 03 Between Years of Formal Education and Raw Scores on Mini-Cog, MMSE, and Animal Language Fluency Tests RESULTS: Delirium was identified in 53 patients (22%); 162 patients (68%) had completed only 4 years of education .
On multivariable analysis, probable cognitive impairment tested by the Mini-Cog (odds ratio [OR] = 1.
57; 95% confidence interval [CI], 0.
70–3.
53; corrected P value >.
999), by the Mini-Mental State Examination (OR = 2.
75; 95% CI, 1.
23–6.
13;corrected P value = .
052), and by the animal verbal fluency test (OR = 1.
24; 95% CI, 0.
49–3.
16; corrected P value >.
999) were not significantly associated with the development of postoperative delirium.
In contrast, lower preoperative Scto2 (OR = 1.
08; 95% CI, 1.
02–1.
14; corrected P value = .
024 for each point decrease in Scto2) was associated with postoperative delirium.
Results: (238 patients were included in this study) 53 cases (22% ) patients presented with delirium; 162 patients (68%) completed only 4 years of education
.

In multivariate analysis, possible cognitive impairment by the Mini-Cog test (OR 0.
91; 95%CI: 0.
70-3.
53; adjusted P value >.
999), possible cognitive impairment by the Mini-Mental Status Examination Impairment (OR2.
75; 95%CI: 1.
23-6.
13; adjusted P value >.
999), and possible cognitive impairment on the verbal fluency test (OR1.
24; 95%CI: 0.
49-3.
16; adjusted P value >.
999) was not significantly associated with the occurrence of postoperative delirium
.

In contrast, lower preoperative Scto2 (1.
08; 95% CI: 1.
02-1.
14; adjusted P value = .
024 for each 1 decrease in Scto2) was associated with postoperative delirium
.

04 CONCLUSIONS: We did not find enough evidence to suggest that poor preoperative cognitive performance of postoperative surgical delirium in an older Portuguese population with an overall low level of formal education, but rather that preoperative cognitive performance of postoperative surgical delirium in an older Portuguese population with an overall low level of formal education, but rather that preoperative cognitive2 may be helpful in Identifying patients at risk for delirium.
Conclusions: We found insufficient evidence to suggest that poor preoperative cognitive ability was significantly associated with postoperative delirium among elderly surgical patients in Portugal with a lower overall level of formal education
.

However, preoperative Scto2 may help identify patients at risk for delirium
.

05Article source "ANESTHESIA & ANALGESIA" Category: Home > SCI Journals > International Journal of Medicine: 0003-2999 2020 Impact Factor/JCR Division: 4.
305/Q2 Publishing Country or Region: UNITED STATES Publishing Cycle: Monthly Publishing Year: 1957 Number of Articles: 425 Study Notes Design Ideas Professional English (*The emphasis is on the repeated key terms in the previous issue and this issue) postoperative delirium POD postoperative delirium regional cerebral oxygen saturation (Scto2) local cerebral oxygen saturation Near-infrared spectroscopy (NIRS) near-infrared spectroscopy undergoing elective surgery prospective observational cohort study prospective observational study ※prospective cohort prospective group multivariable logistic regression multivariate logistic regression analysis false-positive rate univariate analysis univariate analysis cognitive impairment cognitive impairment Knowledge screening test geriatric patients geriatric patients general surgery general surgery urology urology vascular surgery vascular surgery neurosurgery neurosurgery orthopedics orthopedics otorhinolaryngology ophthalmology and otolaryngology maxilofacial surgery maxilofacial surgery ophthalmology ophthalmology plastic surgery plastic surgery dementia dementia Click the blue word to follow us