A Clinical Observational Study Of Early Post Operative Cognitive Dysfunction After Anesthesia

Objective Postoperative cognitive dysfunction (POCD) has been considered as a worldwide difficult topic. More and more researchers have been paid attention to resolving this problem. The aim of our research is to conduct a clinical observational study to investigate the prevalence and the risk factors of young and adult patients who occurring POCD after non-cardiac surgery.Methods We conducted a prospective observational study of a single group. We included patients, aged 18 years to 60 years, undergoing elective surgery with general anesthesia. The type of surgery didn't include cardiac surgery and brain surgery. Patients were tested by Mini Mental Scale test (MMSE) at the first day before surgery and were checked again at the seventh day after the surgery, the results of each test were recorded. If the later test result of a patient is less 2 or more score than the former test result, the patient would be diagnosed as POCD. Besides, we surveyed the age groups, with or without past anesthetic and surgical history groups, educational level groups, and duration of anesthesia groups to calculate the incidence of POCD in each group, and conducted the chi-square test to find the discrepancy of each group. We used Binary logistic regression to analyze the relationship between age, with or without past anesthetic and surgical history, educational level and anesthesia duration time and POCD. Statistical software was cited by SPSS 13.0.Results We finally included a total of 108 patients, of whom 22 patients had POCD, the prevalence was 20.37%. The prevalence of POCD for youth group was 9.09%, and for the middle-aged people was 28.12%, there was significant difference between the two groups(P= 0.016); The prevalence of POCD for without past anesthetic and surgical history group was 18.75%, and for past anesthetic and surgical history group was 33.33%, the result showed no significant difference between the two groups (P=0.237); The prevalence of POCD for primary school and junior high school group was 22.22%, and for high schools and universities group was 17.78%, the result indicated no significant difference between the two groups (P=0.572); The prevalence of POCD for duration of anesthesia<3h group was 12.12%, and for duration of anesthesia≥3h was 33.33%, there was a significant difference between the two groups (P= 0.008). Binary Logistic regression showed that both increasing age and prolongation of anesthesia time were the risk factors for the occurrence of POCD, corresponding test results were [OR 3.559, 95% CI (1.017-12.459)] and [OR 3.639,95% CI (1.293-10.241)], respectively. However, the past anesthetic and surgical history and educational level were not significant associated to POCD, corresponding test results were [OR 1.390,95% CI (0.449-4.305)] and [OR 2.485,95% CI (0.581-10.633)] respectively.Conclusions The research, focusing on youth and middle-aged patients, shows that increasing age and prolongation duration of anesthesia are the risk factors of POCD. However, a second anesthesia and surgery, and lower educational level were not associated with the prevalence of POCD.