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Predictors of Cognitive Dysfunction after Major Noncardiac Surgery

Open access
Monk, Terri G., Weldon, B Craig, Garvan, Cyndi W., Dede, Duane E., van der Aa, Maria T., Heilman, Kenneth M., Gravenstein, Joachim S.·2008·Anesthesiology

Abstract

Background: The authors designed a prospective longitudinal study to investigate the hypothesis that advancing age is a risk factor for postoperative cognitive dysfunction (POCD) after major noncardiac surgery and the impact of POCD on mortality in the first year after surgery. Methods: One thousand sixty-four patients aged 18 yr or older completed neuropsychological tests before surgery, at hospital discharge, and 3 months after surgery. Patients were categorized as young (18-39 yr), middle-aged (40-59 yr), or elderly (60 yr or older). At 1 yr after surgery, patients were contacted to determine their survival status. Results: At hospital discharge, POCD was present in 117 (36.6%) young, 112 (30.4%) middle-aged, and 138 (41.4%) elderly patients. There was a significant difference between all age groups and the age-matched control subjects (P < 0.001). At 3 months after surgery, POCD was present in 16 (5.7%) young, 19 (5.6%) middle-aged, and 39 (12.7%) elderly patients. At this time point, the prevalence of cognitive dysfunction was similar between age-matched controls and young and middle-aged patients but significantly higher in elderly patients compared to elderly control subjects (P < 0.001). The independent risk factors for POCD at 3 months after surgery were increasing age, lower educational level, a history of previous cerebral vascular accident with no residual impairment, and POCD at hospital discharge. Patients with POCD at hospital discharge were more likely to die in the first 3 months after surgery (P = 0.02). Likewise, patients who had POCD at both hospital discharge and 3 months after surgery were more likely to die in the first year after surgery (P = 0.02). Conclusions: Cognitive dysfunction is common in adult patients of all ages at hospital discharge after major noncardiac surgery, but only the elderly (aged 60 yr or older) are at significant risk for long-term cognitive problems. Patients with POCD are at an increased risk of death in the first year after surgery.

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Metadata

Authors
Monk, T. G., Weldon, B. C., Garvan, C. W., Dede, D. E., van der Aa, M. T., Heilman, K. M., & Gravenstein, J. S.
Venue
Anesthesiology
Published
2008-01-01
Volume
108
Issue
1
Pages
18-30
ISSN
0003-3022 (ISSN-L)
OpenAlex
W2149615621
Cited by
1,534
References
49
FWCI
44.72
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Predictors of Cognitive Dysfunction after Major Noncardiac Surgery. https://app.cochat.ai/papers/10.1097/01.anes.0000296071.19434.1e
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Monk, T. G., Weldon, B. C., Garvan, C. W., Dede, D. E., van der Aa, M. T., Heilman, K. M., & Gravenstein, J. S. (2008). Predictors of Cognitive Dysfunction after Major Noncardiac Surgery. Anesthesiology. https://doi.org/10.1097/01.anes.0000296071.19434.1e

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