AUTHOR=Li Fangfang , Miao Mengrong , Li Ningning , Zhou Jun , Sun Mingyang , Zhang Jiaqiang 

TITLE=Prevalence of preoperative cognitive impairment among elderly thoracic surgery patients and association with postoperative delirium: a prospective observational study

JOURNAL=Frontiers in Human Neuroscience

VOLUME=17

YEAR=2023

URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2023.1234018

DOI=10.3389/fnhum.2023.1234018

ISSN=1662-5161

ABSTRACT=<sec><title>Background</title><p>Preoperative cognitive impairment (PCI) may increase the incidence of postoperative delirium (POD), yet screening for cognitive impairment is rarely performed. This study hypothesized that Mini-Cog for preoperative cognitive impairment screening predicts postoperative delirium.</p></sec><sec><title>Methods</title><p>The prospective observational study recruited 153 elderly patients presenting for elective thoracic surgery. Cognitive function of these patients was screened using Mini-Cog preoperatively. We considered that patients with Mini-Cog scores ≤ 3 had cognitive impairment. Delirium was assessed using the Short CAM scale on postoperative days 1–5.</p></sec><sec><title>Results</title><p>Of the 153 participants, 54 (35.3%) were assigned to the PCI group, and 99 (64.7%) were assigned to the Normal group. Place of residence, education level, and history of hypertension were significantly different between the two groups (<italic>P</italic> &lt; 0.05). 51 (33.3%) patients developed POD. Multifactorial analysis revealed that PCI (OR = 2.37, <italic>P</italic> = 0.028), older age (OR = 1.13, <italic>P</italic> = 0.009), ASA grade III (OR = 2.75, <italic>P</italic> = 0.012), and longer duration of anesthesia (OR = 1.01, <italic>P</italic> = 0.007) were associated with POD.</p></sec><sec><title>Conclusion</title><p>Preoperative cognitive impairment is strongly associated with POD. Mini-Cog could be recommended for screening PCI.</p></sec><sec><title>Clinical trial registration</title><p><ext-link ext-link-type="uri" xlink:href="https://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>, identifier NCT05798767.</p></sec>