Current Status And Influencing Factors Of Postoperative Cognitive Dysfunction In Elderly Patients Undergoing Upper Abdominal Surgery

Objective:To understand the status of postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery and to analyze the influencing factors of postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery.It provides a reference for postoperative care and rehabilitation guidance for elderly upper abdominal patients,which is helpful for clinical nurses to identify high-risk groups of postoperative cognitive dysfunction and provide a theoretical basis for improving their cognitive function.Methods:This study is a descriptive study using a questionnaire survey.A questionnaire survey was conducted among 207 elderly patients who underwent upper abdominal surgery under the general anesthesia of the Department of Gastrointestinal Surgery,Pancreatic Surgery,and Hepatobiliary Surgery from the First Affiliated Hospital of China Medical University from December 2017 to December 2018.Research tools include demographics,disease-related data,the Beijing version of the Montreal Cognitive Assessment Scale（MoCA）,the Pittsburgh Sleep Quality Index（PSQI）,the Self-rating Anxiety Scale（SAS）,and the Visual Analog Pain Scale（VAS）.).The data was entered using EpiData3.1 software,and the data was collated and analyzed using SPSS22.0 software.Statistical methods included descriptive analysis,independent sample t-test,one-way ANOVA,Spearman correlation analysis,and logistic regression.The two-sided test was statistically significant at P<0.05.Results:1.Of the 207 patients in this study,50（24.20%）had postoperative POCD,including37 males（74.00%）and 13 females（26.00%）;157（75.80%）did not have POCD.There were 88 males（56.10%）and 69 females（43.90%）.2.Univariate analysis of patient demographics and disease-related data showed age,alcohol consumption,sleep quality（PSQI）,intraoperative hemoglobin（Hb）,calcium(Ca²⁺),gamma glutamyl transferase（GGT）,Alanine aminotransferase（ALT）,creatine kinase（CK）,serum direct bilirubin（DBIL）,serum total bile acid（TBA）,preoperative anxiety（SAS）,postoperative pain（VAS）for patients Postoperative cognitive function has a significant impact.3.Unconditional multivariate logistic regression analysis showed that factors such as age,alcohol consumption,sleep quality,preoperative anxiety and postoperative pain were the influencing factors of postoperative cognitive dysfunction in elderly patients undergoing upper abdominal surgery.Conclusions:1.The incidence of postoperative cognitive dysfunction in elderly patients with upper abdominal surgery was 24.20%.2.The main influencing factors of postoperative cognitive dysfunction in elderly patients with upper abdominal surgery are age,alcohol consumption,sleep quality,preoperative anxiety and postoperative pain.