Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

Wan, Jing; Luo, Peiwen; Du, Xinyue; Yan, Hong

doi:10.1042/bsr20194448

Cited by 20 publications

(14 citation statements)

References 37 publications

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“…Due to the influence of various factors during the perioperative period, the patients with POCD may show a decline in memory, attention and social adaptability within a few days after surgery. [ 18 , 19 ] The typical clinical manifestations of POCD are anxiety, personality changes, memory impairment, orientation and perception disorders. [ 20 ] POCD can increase the occurrence of postoperative complications and cost of medical resources, and affect the long-term quality of life of patients.…”

Section: Discussionmentioning

confidence: 99%

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

Fan¹,

Liu²,

Wu³

et al. 2021

Medicine

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Postoperative cognitive dysfunction (POCD) is very common in clinical settings, it is necessary to analyze the risk factors for POCD in elderly patients after laparoscopic surgery to provide insights into clinical surgery management. Elderly patients undergone laparoscopy between September 1, 2018 and March 31, 2020 were included. The mini-mental state examination (MMSE) scale was used to evaluate the POCD, and the characteristics and clinical data of patients with and without POCD were collected and compared. Logistic regression was used to analyze the potential influencing factors. A total of 572 patients with laparoscopic surgery were included. The incidence of POCD was 11.89%. There were significant differences in the history of cerebral infarction, preemptive analgesia, preoperative use of dexmedetomidine, general anesthesia combined with continuous epidural block, duration of surgery, low SpO2 during anesthesia induction, PaCO2 after pneumoperitoneum, postoperative PCEA and VAS score at the third day after operation (all P < .05). Logistic regression analysis revealed that history of cerebral infarction (OR3.12, 1.02∼5.13), low SpO2 during anesthesia induction (OR2.03, 1.19∼4.47), Longer duration of surgery (OR1.82, 1.01∼3.16) were risk factors for POCD in elderly patients with laparoscopic surgery, while postoperative PCEA (OR0.43, 0.01∼0.91), General anesthesia combined with continuous epidural block (OR0.59, 0.04∼0.87), preoperative use of dexmedetomidine (OR0.70, 0.08∼0.94) and preemptive analgesia (OR0.75, 0.13–0.90) were the protective factors for POCD in elderly patients with laparoscopic surgery. For the elderly patients undergoing laparoscopic surgery, the health care providers should be fully alert to the POCD based on those relevant factors.

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Section: Discussionmentioning

confidence: 99%

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

Fan¹,

Liu²,

Wu³

et al. 2021

Medicine

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“…HGB abnormalities will deprive oxygen delivery to the brain and thus attenuate neuronal energy metabolism ( Weiss et al, 2022 ). Deficient oxygen transport may trigger hypoperfusion, cerebral blood flow changes, and disorder of cerebral auto-regulation, which may further lead to cerebral degenerative abnormalities, such as cognitive dysfunction ( Wan et al, 2020 ). In addition, lower HGB tends to be related to iron deficiency anemia, which may facilitate cognitive decline by affecting the synthesis of neurotransmitters and catecholamine metabolism ( Petranovic et al, 2008 ; Yavuz et al, 2012 ).…”

Section: Discussionmentioning

confidence: 99%

A nomogram incorporating red blood cell indices to predict post-stroke cognitive impairment in the intracerebral hemorrhage population

Wang²,

Gong³

et al. 2022

Front. Aging Neurosci.

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BackgroundPost-stroke cognitive impairment (PSCI) plagues 20–80% of stroke survivors worldwide. There is a lack of an easy and effective scoring tool to predict the risk of PSCI in intracerebral hemorrhage (ICH) patients. We aimed to develop a risk prediction model incorporating red blood cell (RBC) indices to identify ICH populations at risk of PSCI.MethodsPatients diagnosed with ICH at the stroke center were consecutively enrolled in the study as part of the development cohort from July 2017 to December 2018, and of the validation cohort from July 2019 to February 2020. Univariable and multivariable analyses were applied in the development cohort to screen the patients for PSCI risk factors. Then, a nomogram based on RBC indices and other risk factors was developed and validated to evaluate its performance in predicting PSCI occurrence.ResultsA total of 123 patients were enrolled in the development cohort, of which 69 (56.1%) were identified as PSCI, while 38 (63.3%) of 60 patients in the validation cohort were identified as PSCI. According to the multivariate analysis, seven independent risk factors, including three RBC indices (hemoglobin, mean corpuscular volume, RBC distribution width), as well as age, education level, hematoma volume, and dominant-hemisphere hemorrhage were incorporated into the model. The nomogram incorporating RBC indices displayed good discrimination and calibration. The area under the receiver operating characteristic curve was 0.940 for the development cohort and 0.914 for the validation cohort. Decision curve analysis and clinical impact curve showed that the nomogram was clinically useful.ConclusionRBC indices are independent and important predictors of PSCI. A nomogram incorporating RBC indices can be used as a reasonable and reliable graphic tool to help clinicians identify high cognition impairment-risk patients and adjust individualized therapy.

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“…that affect blood flow through the brain [11]. Nevertheless, some larger studies have found a trend towards increased morbidity and mortality in haematocrits lower than 22% [12,13,14]. It has been found that the lowest measured haematocrit value of 10% can be an independent stroke factor, and the risk increases for each percentage point of haematocrit decline [15].…”

Section: Discussionmentioning

confidence: 99%

Effect of perioperative blood loss on cognitive function disorders after colon cancer surgery

Bošković¹,

Maric²,

Kovačević³

et al. 2022

Biomedicinska istraž.

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Introduction. Postoperative cognitive dysfunction (POCD) is very common in patients who are treated in intensive care units or in the surgery department after surgery. This increasingly present complication complicates and calls into question the recovery of the operated patient. We assumed that POCD was associated with blood loss in patients undergoing colorectal cancer surgery. Methods. Our study included 60 patients older than 50 years who underwent elective open surgery for colon cancer. The same protocol was performed for each patient: preoperative preparation and anesthesia. All patients completed three psychometric tests (mini mental test - MMT, information test and Hooper test) the day before surgery, one day after surgery and the seventh day after surgery. Results. Cognitive status examined on the basis of the MMT score showed a statistically significant difference in the number of received blood transfusions after surgery on the first day (p = 0.016) and the total number of received blood transfusions (p = 0.026). Cognitive status examined by the information test showed a statistically significant difference (p = 0.025) in the number of received blood transfusions after surgery on the first day. In patients whose cognitive status was examined by the Hooper test, a high statistically significant difference was observed in the number of received blood transfusions after surgery on the first day (p = 0.001). Cognitive status measured on the basis of MMT score showed that there was a statistically significant difference in the average values of the amount of blood given by transfusion after surgery (p = 0.019). Conclusion. There was a statistically significant cognitive dysfunction in patients who had greater blood loss during surgery and the first day after surgery and who received more blood transfusions (more than 600 ml) during and after surgery. The introduction of psychometric tests in the assessment of cognitive functions as well as the choice of surgery may be important factors in the prevention of POCD.

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Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

Cited by 20 publications

References 37 publications

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

The risk factors for cognitive dysfunction in elderly patients after laparoscopic surgery

A nomogram incorporating red blood cell indices to predict post-stroke cognitive impairment in the intracerebral hemorrhage population

Effect of perioperative blood loss on cognitive function disorders after colon cancer surgery

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