Research About The Influencing Factors Of Cognitive Function Change After Laparoscopic Surgery In Patients With Tumor-related Anemia

Background: Postoperative cognitive dysfunction(POCD)which is a common postoperative complication,including delayed neurocognitive recovery(DNR)and postoperative neurocognitive disorder(NCD),impacts quality of life and increases the risk of disability and mortality.Anaemia is related to cognitive impairment,but little is known about it's role in POCD.Therefore,we conducted a prospective study to evaluate the correlation between the anaemia and POCD for the patients undergoing laparoscopic operation.Methods: This prospective observational study included 177 patients who were planned to underwent laparoscopic surgery with anaesthesia lasting more than 120 minutes.Recorded data included demographic information,results of hemoglobin and the Mini-Mental State Examination(MMSE)scores before operation and at seventh day after surgery.The Chinese version of Telephone Interview for Cognitive Status-Modified(TICS-M)was used at 3 month postoperatively to assess cognitive function and the TICS-M scores also wererecorded.Binary logistic regression analysis was conducted to determine the probable risks associated with POCD.Results: We detected POCD in 43(25.3% of 170)at 7 day and POCD in 30(19% of 158)at 3 month after surgery.No significant difference was found in basic information and the score of MMSE on the day before surgery between normal group and anemia group.There were significant differences in the TICS-M scores and the fatigue symptom scores in the EORCT QLQ-C30 between the two groups at 3 month after surgery(P <0.05).Patients who developed POCD at 7 day and POCD 3 month postoperatively were more likely to have a lower education level which was an independent risk factor in multivariate analyses(P <0.05).Multivariate analysis showed that preoperative hemoglobin concentration and age were independent risk factors for patients who develop POCD at 3 month postoperatively(P <0.05).Conclusion: Patients with anemia were susceptible to POCD at 3 month after surgery,but was not significantly correlated with the incidence of POCD at1 week after surgery.Anaemia was an independent risk factors for POCD in tumor patients following laparoscopic surgery at 3 month.Aducation and age were closely related to the occurrence of POCD.Anemia had little effect on postoperative quality of life.