Diabetes, but Not Hypertension and Obesity, Is Associated with Postoperative Cognitive Dysfunction

Lachmann, Gunnar; Feinkohl, Insa; Borchers, Friedrich; Ottens, Thomas H.; Nathoe, Hendrik M.; Sauër, Anne-Mette C.; Dieleman, Jan M.; Radtke, Frank‐Olaf; Dijk, Diederik A Van; Spies, Claudia; Pischon, Tobias

doi:10.1159/000492962

Cited by 29 publications

(22 citation statements)

References 57 publications

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“…It's been reported that through community experiments that higher blood pressure variability is related to the decline in cognitive function of patients assessed by simple mental status examination 46 . Although the systolic blood pressure variability cannot predict whether the risk of dementia in the overall population increases, it is not found in the subgroup of individuals without a history of cardiovascular disease 47 . The systolic blood pressure variability is positively correlated with the risk of dementia 48 .…”

Section: Discussionmentioning

confidence: 96%

The correlation of blood pressure variability and cognitive function in hypertension patients: a meta-analysis

Jin

Zhao

2021

Preprint

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Background: Cognitive impairment is very common in patients with hypertension, it’s necessary to conduct a meta-analysis to evaluate the association of cognitive function and blood pressure variability in patients with hypertension, to provide insights into the clinical management of hypertension and cognitive impairment. Methods: We searched PubMed et al databases for the case-control studies on the association between blood pressure variability and cognitive function up to July 15, 2021. Two researchers independently screened the literature and retrieved the data. RevMan 5.3 was used for data meta-analysis Results: A total of 13 studies involving 2754 patients were included. Meta-analysis indicated that 24-hour systolic [MD= 3.54, 95% CI (2.48, 4.60)] and diastolic [MD=2.43, 95%CI (1.55, 3.31)] blood pressure variation coefficient in the CI group were significantly higher than that of no CI group (all P<0.05). Standard deviation of systolic [MD=2.20, 95% CI (0.27, 4.13)] and diastolic [MD=1.79, 95% CI (0.80, 2.79)] blood pressure variation in the CI group were significantly higher than that of no CI group (all P<0.05). Mean systolic [MD=3.73, 95% CI (0.92, 6.53)]and diastolic [MD = 5.41, 95% CI (0.42, 10.40)] blood pressure variation in the CI group were significantly higher than that of no CI group (all P<0.05). There were no statistically significant differences in the morning peak systolic [MD=7.85,95% CI (-1.30,17.01)] and diastolic [MD=4.44,95% CI (-6.00, 14.89)] blood pressure drop between the CI group and no CI group(all P>0.05). Conclusion: Cognitive impairment in hypertensive patients is closely associated with increased blood pressure variability, and clinical medical staff should pay attention to the management of blood pressure variability in hypertensive patients to reduce the development of cognitive impairments.

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Section: Discussionmentioning

confidence: 96%

The correlation of blood pressure variability and cognitive function in hypertension patients: a meta-analysis

Jin

Zhao

2021

Preprint

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“…Diabetes has the pathophysiological characteristics of inflammation, proliferation, and hypercoagulability. Diabetes is associated with higher stroke risk compared with diabetes-free persons ( 13 , 14 ). Diabetes causes various microvascular and macrovascular disorders often culminating in major clinical complications.…”

Section: Discussionmentioning

confidence: 99%

Prognosis and Risk Factors of Stroke After Thoracic Endovascular Aortic Repair for Stanford Type B Aortic Dissection

Zha

Pan

Zheng

et al. 2022

Front. Cardiovasc. Med.

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Background: Stroke is a severe complication of patients with type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR). Our aim is to identify predictors of stroke after TEVAR.Methods: From February 2016 to February 2019, 445 patients with TBAD who underwent TEVAR were retrospectively analyzed. Univariate and multivariate analyses were performed to identify predictors of stroke after TEVAR.Results: The total incidence of stroke was 11.5%, with transient neurological dysfunction (TND) of 10.6% and permanent neurological dysfunction (PND) of 0.9%. The average age of the patients was 53.0 ± 3.2 years, and the male/female ratio was 1.17. Univariate analysis suggested that age, body mass index (BMI), diabetes mellitus, chronic obstructive pulmonary disease (COPD), the urgency of repair, type of anesthesia, and left subclavian artery (LSCA) processing were potential risks factors of stroke after TEVAR. Multiple logistic regression identified that LSCA coverage (OR = 5.920, 95% CI: 2.077–16.878), diabetes mellitus (OR = 3.036, 95% CI: 1.025–8.995), and general anesthesia (OR = 2.498, 95% CI: 1.002–6.229) were independent predictors of stroke after TEVAR.Conclusions: Left subclavian artery (LSCA) coverage, diabetes mellitus, and general anesthesia were independent risk factors of stroke after TEVAR for TBAD.

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“…Secondly, there was no other control group in the general population that excludes normal cognitive changes. Thirdly, our study included a small proportion of diabetes which was associated with POCD [43] .…”

Section: Discussionmentioning

confidence: 99%

A Randomised Trial: BIS-Guided Anesthesia Decreases The Incidence of Delayed Neurocognitive Recovery And Postoperative Neurocognitive Disorder But Not Postoperative Delirium

Chen¹,

Li²,

Yang³

et al. 2021

Preprint

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Background. Postoperative cognitive dysfunction (POCD) renamed of delayed neurocognitive recovery (up to 30 days) and postoperative neurocognitive disorder (up to 12 months), is a frequent complication of the neurological system associated with poor outcome. This randomised controlled trial was aimed to determine whether bispectral (BIS) monitoring has a correlation with delayed neurocognitive recovery, postoperative neurocognitive disorder, or postoperative delirium (POD).Methods.100 patients were assigned to the BIS group and 97 patients were assigned to the control group in the study. The BIS index was kept in 40-60 in the BIS group, and the depth of anesthesia in the control group was maintained according to anesthetists’ clinical experiences. The cognitive function was evaluated from the first day to the seventh day after the operation and the time of discharge, 1 month, 6th month and 1 year after the operation.Results. The incidence of delayed neurocognitive recovery (3% vs 21.6%, P＜0.001, at 7th day) (1% vs 21.1%, P＜0.001, at 1 month) and postoperative neurocognitive disorder (6.2% vs 21.3%, P=0.002, at 6th month) (4.4% vs 16.3% ,P=0.009, at 1 year) are lower in BIS group. While there is no significant difference between two group in POD (12% vs 19.6%, P=0.144). The average value of intraoperative BIS were lower in BIS group (43.75 vs 50.69,P＜0.001). The postoperative hospitalisation time （9.99 vs 12.41, P＜0.001) and the mortality (5.4% vs 14.4%, P=0.042) was significantly decreased while the satisfaction is higher in BIS group (39% vs 24.7%, P=0.009). Conclusions. Using BIS can decrease delayed neurocognitive recovery and postoperative neurocognitive disorder, while it is not associated with POD. BIS-monitoring can validly lessen the postoperative hospitalisation and mortality, and increase the satisfaction of patients.Clinical trial registration. Chinese Clinical Trial Registry, ChiCTR2000032463. http://www.chictr.org.cn/showproj.aspx?proj=33065

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Diabetes, but Not Hypertension and Obesity, Is Associated with Postoperative Cognitive Dysfunction

Cited by 29 publications

References 57 publications

The correlation of blood pressure variability and cognitive function in hypertension patients: a meta-analysis

The correlation of blood pressure variability and cognitive function in hypertension patients: a meta-analysis

Prognosis and Risk Factors of Stroke After Thoracic Endovascular Aortic Repair for Stanford Type B Aortic Dissection

A Randomised Trial: BIS-Guided Anesthesia Decreases The Incidence of Delayed Neurocognitive Recovery And Postoperative Neurocognitive Disorder But Not Postoperative Delirium

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