Risk factors for postoperative cognitive dysfunction in elderly patients undergoing total knee arthroplasty / 中华麻醉学杂志

ABSTRACT

Objective To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty (TKA).Methods Ninety-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 65-80 yr,with body mass index of 18-25 kg/m2,undergoing elective TKA under total Ⅳ anesthesia,were divided into POCD group and non-POCD group according to whether POCD occurred on 7th day after surgery.The patient baseline characteristics in the perioperative period,plasma concentrations of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNFα),neuron-specific enolase (NSE) and S-100β protein,and visual analogue scale (VAS) scores at 1 and 2 days after operation were recorded.Logistic regression analysis was used to identify the risk factors for POCD.Results Thirty-eight patients developed POCD at 7 days after operation,and the incidence was 39％.The results of logistic regression analysis showed that the number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma were risk factors for POCD (P＜0.05).Conclusion The number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma are risk factors for POCD in elderly patients undergoing TKA.