Early postoperative cognitive dysfunction is associated with higher cortisol levels in aged patients following hip fracture surgery

Along with ages, elderly patients with comorbid who undergoing surgical procedures are more likely to experience cognitive disorders such as decreased quality of life and loss of independence. This is known as postoperative cognitive dysfunction. The percentage is quite significant for old age to experience cognitive disorders. Ages, education level, health and mental status can be a factor causing cognitive disorders. Comprehensive assessment of objective mental, social and functional status can increase patient preoperative. Perioperative pharmacological management can reduce the incidence of POCD. For example, minimal use of propofol in spinal anesthesia may reduce POCD in hip fracture surgery. The use of dexmedetomidine in ventilated patients in the ICU may also reduce POCD. The etiology is still unclear, but there is a suspicion that the use of neurotoxic anesthetics can trigger the occurrence of POCD, but this has not been further proven.

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Postoperative serum thioredoxin concentrations correlate with delirium and cognitive dysfunction after hip fracture surgery in elderly patients

Clinica Chimica Acta ◽

10.1016/j.cca.2017.01.009 ◽

2017 ◽

Vol 466 ◽

pp. 93-97 ◽

Cited By ~ 5

Author(s):

Xiao-Min Wu ◽

Wei-Cai Xu ◽

Yong-Jian Yu ◽

Liang Han ◽

Jun Zhang ◽

...

Keyword(s):

Hip Fracture ◽

Elderly Patients ◽

Cognitive Dysfunction ◽

Hip Fracture Surgery ◽

Postoperative Serum ◽

Fracture Surgery ◽

Surgery In Elderly

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Malondialdehyde on postoperative day 1 predicts postoperative cognitive dysfunction in elderly patients after hip fracture surgery

Bioscience Reports ◽

10.1042/bsr20190166 ◽

2019 ◽

Vol 39 (6) ◽

Author(s):

Chunxian Wu ◽

Bin Gao ◽

Yu Gui

Keyword(s):

Risk Factor ◽

Hip Fracture ◽

Independent Risk Factor ◽

Postoperative Cognitive Dysfunction ◽

Curve Analysis ◽

Elderly Subjects ◽

Multivariate Logistic Regression ◽

Roc Curve Analysis ◽

Hip Fracture Surgery ◽

Fracture Surgery

Abstract Background: Postoperative cognitive dysfunction (POCD) is a great problem for anesthetized subjects and is associated with poor short- and long-term outcomes. We explored promising predictors for POCD in elderly patients after hip fracture surgery. Methods: Elderly subjects (aged ≥65 years) undergoing surgery for hip fracture were consecutively recruited. Neuropsychological assessments were performed 1 day preoperatively (baseline) and 7 days postoperatively, and POCD was defined using the ‘Z scores’ method. Clinical data and laboratory tests were compared between patients with and without POCD development. Binary univariate and multivariate logistic regression analyses were conducted for risk factor assessment. Receiver operating characteristic (ROC) curve analysis was performed to investigate the predictive value of malondialdehyde (MDA) on postoperative day 1 (POD1) for POCD. Results: A total of 198 patients were finally enrolled in the analysis and 51 patients exhibited POCD within 7 postoperative days, with an incidence rate of 25.8%. MDA expression on POD1 (OR: 1.12, 95%CI: 1.03–1.23, P=0.017) was the only independent risk factor for POCD according to the final multivariate logistic regression analysis. ROC curve analysis indicated that MDA on POD1 was a predictor for POCD, with an area under the curve (AUC) of 0.683 and 95%CI of 0.590–0.775 (P<0.001). Conclusions: In conclusion, we demonstrated that MDA on POD1 was an independent risk factor for POCD in elderly subjects undergoing hip fracture surgery.

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