Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study

Møller, Jes Fabricius; Cluitmans, Pjm Pierre; Rasmussen, Lars S.; Houx, PJ; Rasmussen, Henrik Berg; Canet, Jaume; Rabbitt, Patrick; Jolles, J.; Strandberg‐Larsen, Katrine; Hanning, C.D.; Langeron, Olivier; Johnson, Tim; Lauven, P. M.; Kristensen, P A; Biedler, A.; Beem, H. Van; Fraidakis, O.; Silverstein, J. H.; Beneken, Jew Jan; Gravenstein, J. S.

doi:10.1016/s0140-6736(97)07382-0

Cited by 2,094 publications

(1,210 citation statements)

References 27 publications

Supporting

Mentioning

1,112

Contrasting

Unclassified

Order By: Relevance

“…2 In non-cardiac surgery, an international trial of elderly patients (median age 68, range 60-81 yr) demonstrated a 26% incidence of POCD one week after surgery, with 10% having persistent POCD three months later. 3 Younger patients (median age 51, range 40-60 yr) had a lesser incidence of POCD at one week postoperatively (19%), and this decreased to 6% after three months, similar to that of control subjects. 4 These studies were unable to distinguish between the contribution of major surgery and anesthesia to the observed incidence of POCD.…”

Section: Conclusion : Le Premier Jour Après Une Opération Mineure L'mentioning

confidence: 54%

“…Risk factors for POCD identified by these studies included advancing age, duration of anesthesia, and repeat surgery. [1][2][3][4] Serum markers of neuronal injury, S-100ß protein and Neuron-Specific Enolase (NSE) have been evaluated after different kinds of surgery, with conflicting results. [5][6][7][8] Levels are elevated after cardiac surgery and S-100ß protein in particular may be correlated to POCD after some types of non-cardiac surgery.…”

Section: Conclusion : Le Premier Jour Après Une Opération Mineure L'mentioning

confidence: 99%

See 1 more Smart Citation

Increased incidence of postoperative cognitive dysfunction 24 hr after minor surgery in the elderly

Rohan

Buggy

Crowley

et al. 2005

Can J Anesth/J Can Anesth

110

View full text Add to dashboard Cite

P Pu ur rp po os se e: : Postoperative cognitive dysfunction (POCD) is evident in 26% of elderly patients seven days after major non-cardiac surgery. Despite the growing popularity of day surgery, the influence of anesthetic techniques on next day POCD has not been investigated. Therefore, we evaluated the incidence of POCD and changes in serum markers of neuronal damage (S-100ß protein and Neuron-Specific Enolase), 24 hr after single-agent propofol or sevoflurane anesthesia in elderly patients undergoing minor surgery.M Me et th ho od ds s: : Patients (n = 30, mean age 73, range 65-86 yr) coming for cystoscopy or hysteroscopy, were randomized, in an observer-blind design, to receive either single-agent propofol or sevoflurane anesthesia. Changes in neuropsychological tests (the Stroop test and the modified Word-Recall Test), 24 hr postoperatively were compared with age-matched control subjects (n = 15) using Z-score analysis. Changes in S-100ß protein and NeuronSpecific Enolase levels were also documented.R Re es su ul lt ts s: : POCD was present in 7/15 [47% (95% confidence interval (CI) 21 to 72%)] patients who received propofol and 7/15 [47% (95% CI 21 to 72%)] patients who received sevoflurane, compared with 1/15 [7% (95% CI 6 to 19%)] control patients, P = 0.03. S-100ß protein and Neuron-Specific Enolase levels were not significantly different in anesthetized patients postoperatively compared with preoperative values. C Co on nc cl lu us si io on n: : The incidence of POCD in elderly patients on the first day after minor surgery is higher than previously reported for seven days after major surgery, and is increased after both propofol and sevoflurane anesthesia, compared with age-matched controls. S-100ß protein and Neuron-Specific Enolase levels were unaffected by anesthetic technique. Objectif : Le dysfonctionnement cognitif postopératoire (DCPO) se manifeste chez 26 % des patients âgés, sept jours après une opéra-tion non cardiaque majeure. Nous avons évalué l'incidence de DCPO et les modifications des marqueurs sériques d'atteinte neuronale (protéine S-100ß et énolase neurospécifique), 24 h après une anesthésie à un seul médicament, le propofol ou le sévoflurane, chez des patients âgés qui ont subi une opération mineure. Méthode : Les patients (n = 30, moyenne de 73 ans, limites de 65-86 ans) opérés pour cystoscopie ou hystéroscopie, ont été randomisés à l'insu d'un observateur pour une anesthésie avec propofol ou sévoflurane. Les changements aux tests neuropsychologiques (test Stroop, test modifié de remémoration de mots) ont été notés 24 h après l'opération et comparés à ceux de sujets témoins appariés selon

show abstract

Section: Conclusion : Le Premier Jour Après Une Opération Mineure L'mentioning

confidence: 54%

Section: Conclusion : Le Premier Jour Après Une Opération Mineure L'mentioning

confidence: 99%

Increased incidence of postoperative cognitive dysfunction 24 hr after minor surgery in the elderly

Rohan

Buggy

Crowley

et al. 2005

Can J Anesth/J Can Anesth

110

View full text Add to dashboard Cite

show abstract

“…The international study on post‐operative cognitive dysfunction (ISPOCD 1) study published in the lancet in 1998 demonstrated long‐term POCD in elderly patients undergoing non‐cardiac surgery 90. However, the second study published in 2003 (ISPOD2) found no significant difference in the incidence of cognitive dysfunction 3 months after either general or regional anaesthesia 91.…”

Section: Surgery and Cognitive Dysfunctionmentioning

confidence: 99%

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Scott

Baldini

Fearon

et al. 2015

Acta Anaesthesiol Scand

346

198

View full text Add to dashboard Cite

BackgroundThe present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery.MethodsThe physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care.ResultsThe pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed.ConclusionsEvidence‐based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

show abstract

“…Rudolph and Marcantonio reported that the rate of postoperative delirium ranges from 5 % to approximately 50 %, depending on the type of surgery [8]. Moller et al reported that approximately 25 % of elderly patients exhibit cognitive deterioration for one week after non-cardiac procedures and 10 % exhibit dysfunction for 3 months after major surgery under general anesthesia [9]. However, several months after surgery, the incidence decreases to less than half of the patients, and at one year after surgery, decreases to approximately one-quarter of patients.…”

Section: Current Understanding Of Postoperative Cognitive Dysfunctionmentioning

confidence: 99%

“…Most previous studies that utilized the neurological assessments used in cardiac surgery studies failed to detect any cognitive dysfunction after non-cardiac surgery. More recent studies have identified other factors associated with cognitive dysfunction, i.e., age, preoperative level of education and postoperative complications are listed as risk factors, while the effect of type of anesthesia may be minor [9,15].…”

Section: Risk Factors and Proposed Mechanisms Of Cognitive Dysfunctionmentioning

confidence: 99%

Management of cognition as reported in Japanese historical documents and modern anesthesiology research papers

Saito

2016

J Anesth

View full text Add to dashboard Cite

Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study

Abstract: Our findings have implications for studies of the causes of cognitive decline and, in clinical practice, for the information given to patients before surgery.

Cited by 2,094 publications

References 27 publications

Increased incidence of postoperative cognitive dysfunction 24 hr after minor surgery in the elderly

Increased incidence of postoperative cognitive dysfunction 24 hr after minor surgery in the elderly

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Management of cognition as reported in Japanese historical documents and modern anesthesiology research papers

Contact Info

Product

Resources

About